Site of positive surgical margins influences biochemical recurrence after radical prostatectomy

Godoy, Guilherme; Tareen, Basir; Lepor, Herbert

doi:10.1111/j.1464-410x.2009.08688.x

Cited by 69 publications

(69 citation statements)

References 23 publications

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“…Multifocality of PSMs is predictive of higher BCR rates, but the location of PSMs is less established as a predictor [11] . Godoy et al [7] found in 128 men with PSMs after RP that 5-year actuarial BCR rates varied based on the following rank order of sites of PSMs: base 1 posterolateral 1 apex (100, 49.7, 41.5%, respectively). Tumour volume, lymph node positivity, and the number of positive lymph nodes can also predict BCR [12][13][14] .…”

mentioning

confidence: 99%

Prostate Volume and Its Correlation with Histopathological Outcomes in Prostate Cancer

Sooriakumaran¹,

Srivastava²,

Bhagat³

et al. 2011

Urol Int

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Introduction: There is a paucity of data investigating the relationship between histopathological variables of oncologic importance and prostate volume, and we aimed to investigate this. Patients and Methods: 2,207 consecutive patients who underwent robotic-assisted radical prostatectomy were studied. Preoperative demographic and both pre- and postoperative histopathological parameters were compared among the small (<40 cm³), intermediate (40–70 cm³), and large (>70 cm³) prostate groups. Results: Patients with smaller prostates were younger, had slightly lower BMIs, and lower prostate-specific antigen (PSA) levels than those with larger prostates (p < 0.001). They also had worse histopathological criteria (Gleason, core positivity, and maximum percent cancer) on preoperative biopsy and had worse radical specimen Gleason sums (p < 0.001), percent cancer (p < 0.001), and pathological stage (p = 0.016). 11.5% of the men in the small prostate group suffered a positive surgical margin (PSM) compared to 8.3 and 5.6% in the intermediate and large prostate groups, respectively (p = 0.008). Basilar, posterolateral, and multifocal PSMs were commoner in the small prostate group. Conclusions: Younger men have smaller prostates and worse preoperative histopathological parameters despite lower PSA values. Men with small prostates undergoing robotic-assisted radical prostatectomy have worse final Gleason sums, tumour volume, extraprostatic extension, and PSM rates than those with larger prostates.

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confidence: 99%

Prostate Volume and Its Correlation with Histopathological Outcomes in Prostate Cancer

Sooriakumaran¹,

Srivastava²,

Bhagat³

et al. 2011

Urol Int

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“…By contrast, many studies have shown that quite a lot of men with positive surgical margins never develop biochemical relapse (8)(9)(10).…”

Section: Discussionmentioning

confidence: 93%

“…On the other hand, several other studies have demonstrated that many men with positive surgical margins do not develop biochemical recurrence (8)(9)(10). As patients with positive surgical margins show an unpredictable clinical course, their proper management still remains controversial.…”

Section: Introductionmentioning

confidence: 99%

Predictors of Biochemical Failure Following Radical Prostatectomy With Positive Surgical Margins

Mofid

Kakroodi²,

Simforoosh

et al. 2015

Rep Radiother Oncol

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Background: Radical prostatectomy is an established treatment modality for prostate cancer. Following radical prostatectomy, patients with positive surgical margins have increased risk of biochemical, and subsequently, clinical relapse. However, not all patients with positive margins will suffer disease recurrence. The aim of this study was to assess the factors that might predict the higher risk of disease recurrence in prostate cancer patients with positive surgical margins. Objectives: The aim of this study was to assess the factors that might predict the higher risk of disease recurrence in prostate cancer patients with positive surgical margins. Patients and Methods: From March 2009 till October 2013, seventy seven patients who had pathologically proven positive surgical margins after radical prostatectomy were followed and serum PSA levels were measured every three months. In case of biochemical failure, they were treated with salvage radiotherapy. Apart from pre-op and serial post-op PSA levels, number of positive margins based on anatomical classification of prostate, lymphovascular and perineural invasion, Gleason score and T-stage of the cancer were documented accurately. Results: Fifty one patients (66.2%) had a single positive margin, while 26 (33.8%) had multiple positive margins. Among all 77 patients, 67 (87%) had biochemical failure. Cox regression analysis showed that among various parameters, only pre-op PSA>20ng/ml and having more than one positive margins were able to predict the likelihood of biochemical failure in the patients; while Gleason score, perineural invasion and lymphovascular invasion did not seem to have an important role in this regard. Conclusions: Among patients with positive surgical margins after radical prostatectomy, those with pre-op PSA>20ng/ml or more than one positive margins are at greater risk of biochemical or/and clinical failure. In these patients, starting salvage radiotherapy after surgery might be considered as a logic option.

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“…Similar results were found in other studies (7,(18)(19)(20). Godoy et al (21) found that even the exact site of positive surgical margins -namely, anterior and basilar -was important and correlated with biochemical recurrence even more than the number of positive margins.…”

Section: Discussionmentioning

confidence: 99%

High-risk prostate cancer: factors predicting biochemical recurrence after radical prostatectomy

Ulys¹,

Ulytė²,

Dziameshka³

et al. 2015

AML

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Background/objective. Predictive criteria are needed to evaluate the risk of disease progression after radical prostatectomy. Such criteria would help to select patients most likely to benefit from adjuvant or multimodality treatment. Our aim was to identify predictive factors for biochemical recurrence among the pre-and post-operative parameters in high-risk prostate cancer patients after radical prostatectomy.Methods. Data on high-risk prostate cancer patients between 2005 and 2009 were retrospectively reviewed in two cancer centers: National Cancer Institute, Vilnius, Lithuania, and N. N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus. 199 patients were selected for the study. The pre-operative independent variables were T stage, pretreatment PSA level and Gleason score. Surgical margins and perineural invasion were additionally known for 122 patients. The outcomes measured were biochemical recurrence free and overall survival. The mean follow-up time was 5.8 years.Results. Lower T stage (p = 0.001) and pretreatment PSA (p = 0.0001) were associated with better survival. In the multivariate analysis of pre-operative factors, high T stage (p = 0.008) and pretreatment PSA (p = 0.009) were predictive of biochemical recurrence. When postoperative parameters were included in the multivariate analysis, only pretreatment PSA (p = 0.01), positive surgical margins (p = 0.003) and perineural invasion (p = 0.03) remained relevant independent predictors of biochemical recurrence.Conclusions. Pretreatment PSA, positive surgical margins and perineural invasion were independent predictors of biochemical recurrence after radical prostatectomy in high-risk prostate cancer patients, while the T stage became insignificant after adjusting for postoperative parameters.

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Site of positive surgical margins influences biochemical recurrence after radical prostatectomy

Cited by 69 publications

References 23 publications

Prostate Volume and Its Correlation with Histopathological Outcomes in Prostate Cancer

Prostate Volume and Its Correlation with Histopathological Outcomes in Prostate Cancer

Predictors of Biochemical Failure Following Radical Prostatectomy With Positive Surgical Margins

High-risk prostate cancer: factors predicting biochemical recurrence after radical prostatectomy

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