Impact of surgical margin status on long-term cancer control after radical prostatectomy

2006 ◽  
Vol 98 (6) ◽  
pp. 1199-1203 ◽  
Author(s):  
Marcelo A. Orvieto ◽  
Nejd F. Alsikafi ◽  
Arieh L. Shalhav ◽  
Brett A. Laven ◽  
Gary D. Steinberg ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Surgical Margin ◽  
Cancer Control ◽  
Margin Status

scholarly journals The Long-Term Outcomes after Radical Prostatectomy of Patients with Pathologic Gleason 8–10 Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Dan Lewinshtein ◽  
Brandon Teng ◽  
Ashley Valencia ◽  
Robert Gibbons ◽  
Christopher R. Porter
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Cox Regression ◽  
Surgical Margin ◽  
Cancer Control ◽  
Positive Surgical Margin ◽  
Cancer Specific Survival ◽  
Free Survival ◽  
Kaplan Meier

Background. We explored the long-term clinical outcomes including metastases-free survival and prostate cancer-specific survival (PCSS) in patients with pathologic Gleason 8–10 disease after radical prostatectomy (RP).Methods. We report on 91 patients with PCSS data with a median followup of 8.2 years after RP performed between 1988 and 1997. Cox regression and Kaplan-Meier analysis were used to evaluate year of surgery, pathologic stage, and surgical margin status as predictors of PCSM.Results. Median age was 65 years (IQR: 61–9), and median PSA was 9.7 ng/ml (IQR: 6.1–13.4). Of all patients, 62 (68.9%) had stage T3 disease or higher, and 48 (52.7%) had a positive surgical margin. On multivariate analysis, none of the predictors were statistically significant. Of all patients, the predicted 10-year BCR-free survival, mets-free survival, and PCSS were 59% (CI: 53%–65%), 88% (CI: 84%–92%), and 94% (CI: 91%–97%), respectively.Conclusions. We have demonstrated that cancer control is durable even 10 years after RP in those with pathologic Gleason 8–10 disease. Although 40% will succumb to BCR, only 6% of patients died of their disease. These results support the use of RP for patients with high-risk localized prostate cancer.

Population-based comparison of surgical margin status for robotic versus open radical prostatectomy.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 51-51
Author(s):  
Jim C. Hu ◽  
Giorgio Gandaglia ◽  
Paul Linh Nguyen ◽  
Quoc-Dien Trinh ◽  
Ya-Chen T. Shih ◽  
...  
Keyword(s):  
High Risk ◽  
Radical Prostatectomy ◽  
Odds Ratio ◽  
Surgical Margin ◽  
Cancer Control ◽  
Margin Status ◽  
Surgical Margins ◽  
Positive Surgical Margins ◽  
Open Radical Prostatectomy ◽  
High Risk Disease

51 Background: Robotic-assisted radical prostatectomy (RARP) remains controversial due to exaggerated marketing claims, higher costs, hidden risks, and few clinically significant benefits, including an absence of improved cancer control compared to open radical prostatectomy (ORP). The purpose of our study is to compare surgical margin status by surgical approach. Methods: We identified 13,434 men with a histologically confirmed, non-metastatic prostate cancer treated with RARP versus ORP during 2004 and 2009 from Surveillance, Epidemiology, and End Results (SEER)–Medicare linked data. Propensity-based analyses were performed to minimize treatment selection biases. Generalized linear regression models were computed for comparison of radical prostatectomy surgical margin status by surgical approach. Results: During the study period, 5,556 and 7,878 men underwent RARP and ORP, respectively. In the propensity-adjusted cohort, the incidence of positive surgical margins was significantly lower among men undergoing RARP versus ORP (13.7% vs. 18.4%, odds ratio [OR]: 0.68, 95% confidence interval [CI]: 0.63–0.73, p<0.001). This reduction in the incidence of positive surgical margins of RARP over ORP was more pronounced among men with more advanced disease—6.6% lower absolute incidence of positive margins among men with intermediate- and high-risk disease (p<0.001, respectively) and 15.4% lower absolute incidence of positive margins among men with extracapsular extension (p<0.001). Moreover, RARP was associated with lower odds of positive surgical margins compared to ORP for pT2 (Odds Ratio [OR] 0.67, 95% Confidence Interval [CI] 0.61–0.74, p<0.001) and pT3a (OR 0.72, 95% CI 0.60–0.85, p<0.001) disease. Additionally, RARP was associated with lower odds of positive surgical margins for intermediate (OR 0.66, 95% CI 0.58–0.74) and high-risk (OR 0.69, 95% CI 0.64–0.75) disease. Conclusions: RARP was associated with improved surgical margin status among men with intermediate and high-risk disease. This has important implications for cancer control, patient quality of life, health care delivery and additional costs of downstream therapies.

144: Surgical Margin Status in European Versus North American Patients at Radical Prostatectomy

2006 ◽  
Vol 175 (4S) ◽  
pp. 46-47
Author(s):  
Daniel J. Lewinshtein ◽  
K.-H. Felix Chun ◽  
Alberto Briganti ◽  
Hendrik Isbarn ◽  
Eike Currlin ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
North American ◽  
Surgical Margin ◽  
Margin Status

scholarly journals Positive Surgical Margin Status after Minimally Invasive Radical Prostatectomy: a Multicenter Study

2015 ◽  
Vol 82 (4) ◽  
pp. 229-237
Author(s):  
Ardit Tafa ◽  
Angelica Grasso ◽  
Alessandro Antonelli ◽  
Pierluigi Bove ◽  
Antonio Celia ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Minimally Invasive ◽  
Multicenter Study ◽  
Surgical Margin ◽  
Margin Status ◽  
Positive Surgical Margin

Variation in positive surgical margin status following radical prostatectomy for pT2 prostate cancer

2019 ◽  
Vol 18 (1) ◽  
pp. e294-e295
Author(s):  
W.S. Tan ◽  
M. Krimphove ◽  
A. Cole ◽  
S. Berg ◽  
M. Marchese ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Surgical Margin ◽  
Margin Status ◽  
Positive Surgical Margin

Biochemical Recurrence After Radical Prostatectomy: Multiplicative Interaction Between Surgical Margin Status and Pathological Stage

2010 ◽  
Vol 184 (4) ◽  
pp. 1341-1346 ◽  
Author(s):  
Lars Budäus ◽  
Hendrik Isbarn ◽  
Christian Eichelberg ◽  
Giovanni Lughezzani ◽  
Maxine Sun ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Biochemical Recurrence ◽  
Surgical Margin ◽  
Margin Status ◽  
Pathological Stage ◽  
Multiplicative Interaction

scholarly journals Surgical margin status and its impact on prostate cancer prognosis after radical prostatectomy: a meta-analysis

2018 ◽  
Vol 36 (11) ◽  
pp. 1803-1815 ◽  
Author(s):  
Lijin Zhang ◽  
Bin Wu ◽  
Zhenlei Zha ◽  
Hu Zhao ◽  
Jun Yuan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Meta Analysis ◽  
Surgical Margin ◽  
Margin Status ◽  
Cancer Prognosis ◽  
Prostate Cancer Prognosis

Nomograms to predict 3-year biochemical recurrence after robotic-assisted laparoscopic radical prostatectomy based on preoperative and perioperative variables of 774 patients.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 115-115
Author(s):  
P. Sooriakumaran ◽  
M. John ◽  
A. Srivastava ◽  
Y. El-Douaihy ◽  
S. Grover ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Biochemical Recurrence ◽  
Perineural Invasion ◽  
Clinical Stage ◽  
Surgical Margin ◽  
Margin Status ◽  
Laparoscopic Radical Prostatectomy ◽  
Nerve Sparing ◽  
Robotic Assisted ◽  
Psa Density

115 Background: Predictors of biochemical recurrence after robotic-assisted laparoscopic radical prostatectomy (RALP) are not well reported in the literature. We wanted to investigate preoperative predictors as well as the influence of nerve sparing and positive surgical margin status on 3-year biochemical recurrence. Methods: 774 patients with at least 3 year follow up had undergone RALP by a single surgeon at our institution. Biochemcial recurrence was defined as a postoperative PSA >0.2 ng/ml. Multivariable logistic regression models were used to develop the biochemical recurrence predictive nomograms: nomogram 1- age, BMI, PSA density, clinical stage, biopsy Gleason, percent positive cores, perineural invasion; nomogram 2- age, BMI, PSA density, clinical stage, biopsy Gleason, percent positive cores, perineural invasion, nerve sparing, positive surgical margins (none, unifocal, or multifocal). The predictive accuracy of the models was assessed in terms of discrimination and calibration. Results: Both nomograms discriminated well between patients that recurred and those that did not (bootstrap corrected c-indices of 0.766 and 0.806 for nomograms 1 and 2 respectively). Nomogram 1 was well calibrated, but nomogram 2 over- predicted the probability of biochemical recurrence in patients at >30% risk. Conclusions: Our nomogram based on age, BMI, PSA density, clinical stage, biopsy Gleason, percent positive cores, and perineural invasion on preoperative biopsy has a good predictive ability to differentiate between RALP-treated patients that biochemically recur by 3 years from those that do not. Adding nerve sparing and surgical margin status further improved discriminatory ability but at the expense of over-prediction for patients at high risk. These nomograms may be used to guide the use of nerve sparing and the management of positive margins in men undergoing RALP for clinically localized prostate cancer. No significant financial relationships to disclose.

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