Do Positive Surgical Margins Predict Biochemical Recurrence in All Patients Without Adjuvant Therapy After Radical Prostatectomy?.
10.4111/kju.2013.54.8.510
- Author:
Jun Woo LEE
1
;
Jae Hyun RYU
;
Yun Beom KIM
;
Seung Ok YANG
;
Jeong Kee LEE
;
Tae Young JUNG
Author Information
1. Department of Urology, Veterans Health Service Medical Center, Seoul, Korea. urodoct@hotmail.com
- Publication Type:Original Article
- Keywords:
Prostatectomy;
Prostatic neoplasms;
Recurrence
- MeSH:
Humans;
Male;
Medical Records;
Multivariate Analysis;
Neoplasm Grading;
Prostate-Specific Antigen;
Prostatectomy;
Prostatic Neoplasms;
Recurrence;
Retrospective Studies;
Survival Rate;
Veterans Health
- From:Korean Journal of Urology
2013;54(8):510-515
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The objective was to study whether positive surgical margins (PSMs) predict biochemical recurrence (BCR) in all patients without adjuvant therapy after radical prostatectomy (RP). MATERIALS AND METHODS: We retrospectively reviewed the medical records of patients who underwent RP for prostate cancer at Veterans Health Service Medical Center from 2005 to 2011. BCR was defined by a prostate-specific antigen (PSA) value > or =0.2 ng/mL. The clinicopathological factors of the PSM group were compared with those of the negative surgical margin (NSM) group, and the predictive impact of a PSM for BCR-free survival were evaluated. In addition, we analyzed the prognostic difference for BCR-free survival between solitary and multiple PSMs. RESULTS: A PSM was noted in 167 patients (45.5%). BCR was reported in 101 men in total (27.5%). The BCR-free survival rate of the PSM group was lower than that of the NSM group (p<0.001). In a multivariate analysis for the total patients, PSM was significantly associated with BCR-free survival (p<0.001). After stratification by pathological T stage, Gleason score (GS), and preoperative PSA value, PSM was significantly predictive for BCR-free survival in men with pT2 and/or GS < or =6 or 7 and/or a PSA value <10 or 10-20 ng/mL (all p<0.05). Multiple PSMs were more predictive of BCR-free survival than was a solitary PSM (p=0.001). CONCLUSIONS: A PSM is a significant predictor of postoperative BCR in patients with pT2 and/or GS < or =7 and/or preoperative PSA <20 ng/mL. Multiple PSMs are considered a stronger prognostic factor for prediction of BCR than is a solitary PSM.
