682 ROLE OF POSITIVE SURGICAL MARGINS IN PATIENTS WITH ORGAN CONFINED PROSTATE CANCER. IMPLICATIONS FOR ADJUVANT TREATMENTS

2010 ◽  
Vol 9 (2) ◽  
pp. 224
Author(s):  
A. Briganti ◽  
N. Suardi ◽  
U. Capitanio ◽  
M. Freschi ◽  
A. Salonia ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Surgical Margins ◽  
Positive Surgical Margins

scholarly journals The role of PSA density to predict a pathological tumour upgrade between needle biopsy and radical prostatectomy for low risk clinical prostate cancer in the modified Gleason system era

2013 ◽  
Vol 7 (11-12) ◽  
pp. 722 ◽  
Author(s):  
Stavros Sfoungaristos ◽  
Ioannis Katafigiotis ◽  
Petros Perimenis
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Gleason Score ◽  
Strong Predictor ◽  
Specific Antigen ◽  
Low Risk ◽  
Surgical Margins ◽  
Positive Surgical Margins ◽  
Psa Density

Objectives: We evaluate the role of prostate-specific antigen (PSA) density to predict Gleason score upgrade between prostate biopsy material and radical prostatectomy specimen examination in patients with low-risk prostate cancer.Methods: Between January 2007 and November 2011, 133 low-risk patients underwent a radical prostatectomy. Using the modified Gleason criteria, tumour grade of the surgical specimens was examined and compared to the biopsy results.Results: A tumour upgrade was noticed in 57 (42.9%) patients. Organ-confined disease was found in 110 (82.7%) patients, while extracapsular disease and seminal vesicles invasion was found in 19 (14.3%) and 4 (3.0%) patients, respectively. Positive surgical margins were reported in 23 (17.3%) patients. A statistical significant correlation between the preoperative PSA density value and postoperative upgrade was found (p = 0.001) and this observation had a predictive value (p = 0.002); this is in contrast to the other studied parameters which failed to reach significance, including PSA, percentage of cancer in biopsy and number of biopsy cores. Tumour upgrade was also highly associated with extracapsularcancer extension (p = 0.017) and the presence of positive surgical margins (p = 0.017).Conclusions: PSA density represents a strong predictor for Gleason score upgrade after radical prostatectomy in patients with clinical low-risk disease. Since tumour upgrade increases the potential for postoperative pathological adverse findings and prognosis, PSA density should be considered when treating and consulting patients with low-risk prostate cancer.

1557 ROLE OF POSITIVE SURGICAL MARGINS IN PATIENTS WITH ORGAN CONFINED PROSTATE CANCER. IMPLICATIONS FOR ADJUVANT TREATMENTS

2010 ◽  
Vol 183 (4S) ◽  
Author(s):  
Alberto Briganti ◽  
Nazareno Suardi ◽  
Umberto Capitanio ◽  
Umberto Capitanio ◽  
Andrea Salonia ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Surgical Margins ◽  
Positive Surgical Margins

scholarly journals Positive surgical margins: rate, contributing factors and impact on further treatment: findings from the Prostate Cancer Registry

2014 ◽  
Vol 114 (5) ◽  
pp. 680-690 ◽  
Author(s):  
Sue M. Evans ◽  
Jeremy L. Millar ◽  
Mark Frydenberg ◽  
Declan G. Murphy ◽  
Ian D. Davis ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Registry ◽  
Surgical Margins ◽  
Contributing Factors ◽  
Positive Surgical Margins

scholarly journals Oncological outcome of neoadjuvant low-dose estramustine plus LHRH agonist/antagonist followed by extended radical prostatectomy for Japanese patients with high-risk localized prostate cancer: a prospective single-arm study

2019 ◽  
Vol 50 (1) ◽  
pp. 66-72 ◽  
Author(s):  
Hideki Enokida ◽  
Yasutoshi Yamada ◽  
Shuichi Tatarano ◽  
Hirofumi Yoshino ◽  
Masaya Yonemori ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Radical Prostatectomy ◽  
Cox Regression ◽  
External Beam Radiotherapy ◽  
Oncological Outcome ◽  
Muscle Layer ◽  
Surgical Margins ◽  
Positive Surgical Margins ◽  
Cox Regression Analysis

Abstract Background Patients with advanced high-risk prostate cancer (PCa) are prone to have worse pathological diagnoses of positive surgical margins and/or lymph node invasion, resulting in early biochemical recurrence (BCR) despite having undergone radical prostatectomy (RP). Therefore, it is controversial whether patients with high-risk PCa should undergo RP. The purpose of this study was to evaluate the efficacy of neoadjuvant chemohormonal therapy (NAC) followed by “extended” RP. Methods A total of 87 patients with high-risk PCa prospectively underwent extended RP after NAC; most of the patients underwent 6 months of estramustine phosphate (EMP) 140 mg twice daily, along with a luteinizing hormone-releasing hormone agonist/antagonist. We developed our surgical technique to reduce the rate of positive surgical margins. We aimed to approach the muscle layer of the rectum by dissecting the mesorectal fascia and continuing the dissection through the mesorectum until the muscle layer of the rectum was exposed. Results More than 1 year had elapsed after surgery in all 86 patients, with a median follow-up period of 37.7 months. The 3-year BCR-free survival was 74.9%. Multivariate Cox-regression analysis revealed that a positive core ratio of 50% or greater and pathological stage of pT3 or greater were independent predictors for BCR. About 17 of 23 cases received salvage androgen deprivation therapy and concurrent external beam radiotherapy, and showed no progression after the salvage therapies. Conclusions NAC concordant with extended RP is feasible and might provide good cancer control for patients with high-risk PCa.

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