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Length of positive surgical margin after radical prostatectomy as a predictor of biochemical recurrence.
J Urol. 2009 Jul; 182(1):139-44.JU

Abstract

PURPOSE

Length and location of positive surgical margins are independent predictors of biochemical recurrence after open radical prostatectomy. We assessed their impact on biochemical recurrence in a large robotic prostatectomy series.

MATERIALS AND METHODS

Data were collected prospectively from 1,398 men undergoing robotic radical prostatectomy for clinically localized prostate cancer from 2003 to 2008 at a single institution. The associations of preoperative prostate specific antigen, pathological Gleason score, pathological stage and positive surgical margin parameters (location, length and focality) with biochemical recurrence rate were evaluated. Margin status and length were measured by a single uropathologist. Biochemical recurrence was defined as serum prostate specific antigen greater than 0.1 ng/ml on 2 consecutive tests. Cox regression models were constructed to evaluate predictors of biochemical recurrence.

RESULTS

Of 1,398 consecutive patients who underwent robotic prostatectomy positive margins were present in 243 (17%) (11% of pathological T2 and 41% of T3). Preoperative prostate specific antigen, pathological stage, Gleason score, margin status, and margin length as a continuous and categorical variable (less than 1, 1 to 3, more than 3 mm) were independent predictors of biochemical recurrence. Patients with negative margins and those with a positive margin less than 1 mm had similar rates of biochemical recurrence (log rank test p = 0.18). Surgical margin location was not independently associated with biochemical recurrence.

CONCLUSIONS

Margin status and length are independent predictors of biochemical recurrence following robotic radical prostatectomy. Although longer followup and validation studies are necessary for confirmation, patients with a positive margin less than 1 mm appear to have similar recurrence rates as those with negative margins.

Authors+Show Affiliations

University of Chicago, Chicago, Illinois, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19450829

Citation

Shikanov, Sergey, et al. "Length of Positive Surgical Margin After Radical Prostatectomy as a Predictor of Biochemical Recurrence." The Journal of Urology, vol. 182, no. 1, 2009, pp. 139-44.
Shikanov S, Song J, Royce C, et al. Length of positive surgical margin after radical prostatectomy as a predictor of biochemical recurrence. J Urol. 2009;182(1):139-44.
Shikanov, S., Song, J., Royce, C., Al-Ahmadie, H., Zorn, K., Steinberg, G., Zagaja, G., Shalhav, A., & Eggener, S. (2009). Length of positive surgical margin after radical prostatectomy as a predictor of biochemical recurrence. The Journal of Urology, 182(1), 139-44. https://doi.org/10.1016/j.juro.2009.02.139
Shikanov S, et al. Length of Positive Surgical Margin After Radical Prostatectomy as a Predictor of Biochemical Recurrence. J Urol. 2009;182(1):139-44. PubMed PMID: 19450829.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Length of positive surgical margin after radical prostatectomy as a predictor of biochemical recurrence. AU - Shikanov,Sergey, AU - Song,Jie, AU - Royce,Cassandra, AU - Al-Ahmadie,Hikmat, AU - Zorn,Kevin, AU - Steinberg,Gary, AU - Zagaja,Gregory, AU - Shalhav,Arieh, AU - Eggener,Scott, Y1 - 2009/05/17/ PY - 2008/12/15/received PY - 2009/5/20/entrez PY - 2009/5/20/pubmed PY - 2010/7/2/medline SP - 139 EP - 44 JF - The Journal of urology JO - J Urol VL - 182 IS - 1 N2 - PURPOSE: Length and location of positive surgical margins are independent predictors of biochemical recurrence after open radical prostatectomy. We assessed their impact on biochemical recurrence in a large robotic prostatectomy series. MATERIALS AND METHODS: Data were collected prospectively from 1,398 men undergoing robotic radical prostatectomy for clinically localized prostate cancer from 2003 to 2008 at a single institution. The associations of preoperative prostate specific antigen, pathological Gleason score, pathological stage and positive surgical margin parameters (location, length and focality) with biochemical recurrence rate were evaluated. Margin status and length were measured by a single uropathologist. Biochemical recurrence was defined as serum prostate specific antigen greater than 0.1 ng/ml on 2 consecutive tests. Cox regression models were constructed to evaluate predictors of biochemical recurrence. RESULTS: Of 1,398 consecutive patients who underwent robotic prostatectomy positive margins were present in 243 (17%) (11% of pathological T2 and 41% of T3). Preoperative prostate specific antigen, pathological stage, Gleason score, margin status, and margin length as a continuous and categorical variable (less than 1, 1 to 3, more than 3 mm) were independent predictors of biochemical recurrence. Patients with negative margins and those with a positive margin less than 1 mm had similar rates of biochemical recurrence (log rank test p = 0.18). Surgical margin location was not independently associated with biochemical recurrence. CONCLUSIONS: Margin status and length are independent predictors of biochemical recurrence following robotic radical prostatectomy. Although longer followup and validation studies are necessary for confirmation, patients with a positive margin less than 1 mm appear to have similar recurrence rates as those with negative margins. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/19450829/Length_of_positive_surgical_margin_after_radical_prostatectomy_as_a_predictor_of_biochemical_recurrence_ L2 - https://www.jurology.com/doi/10.1016/j.juro.2009.02.139?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -