Radical prostatectomy with positive surgical margins: how are patients managed?

Thurairaja, Ramesh; Osborn, Jonathan; McFarlane, Jonathan; Bahl, Amit; Persad, Rajendra

doi:10.1111/j.1464-410x.2006.05997.x

Cited by 4 publications

(3 citation statements)

References 51 publications

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“…These observations suggest the utility of further subclassification of positive margins in order to identify patients with higher risks of recurrence. In our study, the overall rate of positive surgical margins was 29.8% in pT3 tumors and up to 90% in other tumors, which is similar to other studies [26–28]. …”

Section: Discussionsupporting

confidence: 92%

Matrix Metalloproteinases 2 and 9 Immunoexpression in Prostate Carcinoma at the Positive Margin of Radical Prostatectomy Specimens

Oguić

Mozetič²,

Tešar

et al. 2014

Pathology Research International

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The aim of this study was to evaluate the expression of matrix metalloproteinase 2 (MMP-2) and matrix metalloproteinase 9 (MMP-9) in prostate cancer in the main tumor mass and tumor cells at the positive margin as well as the influence of these biomarkers on the biochemical recurrence of the disease in prostatectomy patients. Tissue microarrays of 120 archival prostate carcinoma samples were immunohistochemically evaluated for MMP-2 and MMP-9 expression and compared with clinicopathological parameters. Tumors with positive surgical margins showed significantly higher overall expression of MMP-9 versus tumors with negative resection margins (P = 0.0121). MMP-9 expression was significantly elevated in tumors from patients who had biochemical recurrence (P = 0.0207). In the group of patients with negative margins, MMP-9 expression above the cut-off value was significantly associated with recurrence (P = 0.0065). Multivariate analysis indicated that MMP-9 is a good predictor of biochemical recurrence (odds ratio = 10.29; P = 0.0052). Expression of MMP-2 in tumor cells was significantly higher at the positive margins than in the main tumor mass (P = 0.0301). The present results highlight the potential value of MMP-2 and MMP-9 expression for predicting the behavior of prostate tumors after prostatectomy with both positive and negative surgical margins.

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Section: Discussionsupporting

confidence: 92%

Matrix Metalloproteinases 2 and 9 Immunoexpression in Prostate Carcinoma at the Positive Margin of Radical Prostatectomy Specimens

Oguić

Mozetič²,

Tešar

et al. 2014

Pathology Research International

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“…It is extremely difficult to predict PSM outcome, and as patients with PSMs are at higher risk of progression, the ability to stratify this risk needs improvement along with other factors that may affect disease progression and survival (11). Focal capsular or extensive extracapsular involvement, were both correlated with BCR in our study.…”

Section: Discussionmentioning

confidence: 69%

Radical prostatectomy and positive surgical margins: relationship with prostate cancer outcome

et al. 2014

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At univariate analysis, presence, number and location of PSMs have consistent correlation with BCR after RRP, but at follow-up BCR occurred only in 37.8% of patients with PSMs. However at multivariate analysis, the significant risk factors for BCR were percentage of tumor volume (p = 0.022) and Gleason score (p < 0.005) in the surgical specimen. Angiolymphatic invasion and Gleason score were significantly correlated with CR.

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“…Although RP is used in patients with the assumption that there is no locally advanced or metastatic spread, SM+ rates are still significant [74]. As seen in previous studies, patients with SM+ are at greater risk of progression.…”

Section: Surgical Marginmentioning

confidence: 99%

Contemporary Radical Prostatectomy

Moul

Sun

2011

Prostate Cancer

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Purpose. Patients diagnosed with clinically localized prostate cancer have more surgical treatment options than in the past. This paper focuses on the procedures' oncological or functional outcomes and perioperative morbidities of radical retropubic prostatectomy, radical perineal prostatectomy, and robotic-assisted laparoscopic radical prostatectomy. Materials and Methods. A MEDLINE/PubMed search of the literature on radical prostatectomy and other new management options was performed. Results. Compared to the open procedures, robotic-assisted radical prostatectomy has no confirmed significant difference in most literatures besides less blood loss and blood transfusion. Nerve sparing is a safe means of preserving potency on well-selected patients undergoing radical prostatectomy. Positive surgical margin rates of radical prostatectomy affect the recurrence and survival of prostate cancer. The urinary and sexual function outcomes have been vastly improved. Neoadjuvant treatment only affects the rate of positive surgical margin. Adjuvant therapy can delay and reduce the risk of recurrence and improve the survival of the high risk prostate cancer. Conclusions. For the majority of patients with organ-confined prostate cancer, radical prostatectomy remains a most effective approach. Radical perineal prostatectomy remains a viable approach for patients with morbid obesity, prior pelvic surgery, or prior pelvic radiation. Robot-assisted laparoscopic prostatectomy (RALP) has become popular among surgeons but has not yet become the firmly established standard of care. Long-term data have confirmed the efficacy of radical retropubic prostatectomy with disease control rates and cancer-specific survival rates.

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Radical prostatectomy with positive surgical margins: how are patients managed?

Abstract: Mini rev Article RADICAL PROSTATECTOMY WITH POSITIVE SURGICAL MARGINS THURAIRAJA et al.

Cited by 4 publications

References 51 publications

Matrix Metalloproteinases 2 and 9 Immunoexpression in Prostate Carcinoma at the Positive Margin of Radical Prostatectomy Specimens

Matrix Metalloproteinases 2 and 9 Immunoexpression in Prostate Carcinoma at the Positive Margin of Radical Prostatectomy Specimens

Radical prostatectomy and positive surgical margins: relationship with prostate cancer outcome

Contemporary Radical Prostatectomy

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