The association between prostate weight and positive surgical margins in prostate cancer: A meta‐analysis

Andrologia ◽  
2020 ◽  
Vol 52 (3) ◽  
Author(s):  
Ke He ◽  
Zhang‐Jun Cao ◽  
Long‐Fei Peng ◽  
You‐Lu Lu ◽  
Xin Wang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Meta Analysis ◽  
Surgical Margins ◽  
Positive Surgical Margins ◽  
Prostate Weight

scholarly journals Primary Gleason grade and Gleason grade group at positive surgical margins: a systematic review and meta‐analysis

2021 ◽  
Vol 127 (S1) ◽  
pp. 13-22
Author(s):  
Athul John ◽  
Hritik John ◽  
Rick Catterwell ◽  
Luke A Selth ◽  
Michael O Callaghan
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Surgical Margins ◽  
Gleason Grade ◽  
Grade Group ◽  
Positive Surgical Margins

scholarly journals Predictive Factors for Positive Surgical Margins in Patients With Prostate Cancer After Radical Prostatectomy: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 ◽  
Author(s):  
Lijin Zhang ◽  
Hu Zhao ◽  
Bin Wu ◽  
Zhenlei Zha ◽  
Jun Yuan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Predictive Factors ◽  
Meta Analysis ◽  
Positive Lymph Node ◽  
Pathological Stage ◽  
Positive Surgical Margins ◽  
Subgroup Analyses ◽  
Biopsy Gleason Score ◽  
Extraprostatic Extension

Background and ObjectivesPrevious studies have demonstrated that positive surgical margins (PSMs) were independent predictive factors for biochemical and oncologic outcomes in patients with prostate cancer (PCa). This study aimed to conduct a meta-analysis to identify the predictive factors for PSMs after radical prostatectomy (RP).MethodsWe selected eligible studies via the electronic databases, such as PubMed, Web of Science, and EMBASE, from inception to December 2020. The risk factors for PSMs following RP were identified. The pooled estimates of standardized mean differences (SMDs)/odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. A fixed effect or random effect was used to pool the estimates. Subgroup analyses were performed to explore the reasons for heterogeneity.ResultsTwenty-seven studies including 50,014 patients with PCa were eligible for further analysis. The results showed that PSMs were significantly associated with preoperative prostate-specific antigen (PSA) (pooled SMD = 0.37; 95% CI: 0.31–0.43; P < 0.001), biopsy Gleason Score (<6/≥7) (pooled OR = 1.53; 95% CI:1.31–1.79; P < 0.001), pathological Gleason Score (<6/≥7) (pooled OR = 2.49; 95% CI: 2.19–2.83; P < 0.001), pathological stage (<T2/≥T3) (pooled OR = 3.90; 95% CI: 3.18–4.79; P < 0.001), positive lymph node (PLN) (pooled OR = 3.12; 95% CI: 2.28–4.27; P < 0.001), extraprostatic extension (EPE) (pooled OR = 4.44; 95% CI: 3.25–6.09; P < 0.001), and seminal vesicle invasion (SVI) (pooled OR = 4.19; 95% CI: 2,87–6.13; P < 0.001). However, we found that age (pooled SMD = 0.01; 95% CI: −0.07–0.10; P = 0.735), body mass index (BMI) (pooled SMD = 0.12; 95% CI: −0.05–0.30; P = 0.162), prostate volume (pooled SMD = −0.28; 95% CI: −0.62–0.05; P = 0.097), and nerve sparing (pooled OR = 0.90; 95% CI: 0.71–1.14; P = 0.388) had no effect on PSMs after RP. Besides, the findings in this study were found to be reliable by our sensitivity and subgroup analyses.ConclusionsPreoperative PSA, biopsy Gleason Score, pathological Gleason Score, pathological stage, positive lymph node, extraprostatic extension, and seminal vesicle invasion are independent predictors of PSMs after RP. These results may helpful for risk stratification and individualized therapy in PCa patients.

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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