Prognostic value of focal positive surgical margins after radical prostatectomy

Abstract We present a comparision the prognostic significance of focal positive margin (FPM) among patients with clinically localized prostate cancer following radical prostatectomy (RP). FPM after RP did not significantly affect BCR-free survival in all patients or patients with pathologic T2 disea...

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Published in:Clinical genitourinary cancer 2016-08, Vol.14 (4), p.e313-e319
Main Authors: Lee, Sangchul, Kim, Ki Bom, Jo, Jung Ki, Ho, Jin-Nyoung, Oh, Jong Jin, Jeong, Seong Jin, Hong, Sung Kyu, Byun, Seok-Soo, Choe, Gheeyoung, Lee, Sang Eun
Format: Article
Language:English
Subjects:
Aged
Biochemical recurrence
Disease-Free Survival
Focal
Hematology, Oncology and Palliative Medicine
Humans
Male
Margins of Excision
Middle Aged
Positive margin
Prognosis
Prostate
Prostate - pathology
Prostatectomy - methods
Prostatic Neoplasms - mortality
Prostatic Neoplasms - pathology
Prostatic Neoplasms - surgery
Retrospective Studies
Survival Analysis
Urology
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Summary:Abstract We present a comparision the prognostic significance of focal positive margin (FPM) among patients with clinically localized prostate cancer following radical prostatectomy (RP). FPM after RP did not significantly affect BCR-free survival in all patients or patients with pathologic T2 disease. Background The significance of focal positive margins after radical prostatectomy (RP) is unclear. Our objective was to investigate the prognostic value of focal positive margins (FPM) in patients undergoing RP. Materials and Methods Data were analyzed retrospectively for 1,733 patients with clinically localized prostate cancer who underwent RP at our institution between December 2003 and March 2014 without neoadjuvant or adjuvant therapy. Positive surgical margins were characterized as FPM (≤3 mm in length) or non-focal positive margin (>3 mm in length). Multivariate analysis of clinicopathological factors, including FPMs, was performed with respect to biochemical recurrence (BCR)-free survival. Results Among all patients, 1,260 (72.7%) had negative margins, 114 (6.6%) had a focal positive margin, 218 (12.6%) had a non-focal single positive margin, and 141 (8.1%) had non-focal multiple positive margins. Among patients with pathologic T2 prostate cancer, 1,065 (84.3%) had negative margins, 62 (4.9%) had a FPM, 104 (8.2%) had a non-focal single positive margin, and 33 (2.6%) had non-focal multiple positive margins. Five-year BCR-free survival for patients with negative margins and focal positive margins was 90% and 83.4%, respectively. Upon multivariate analysis, presence of a FPM was not a significant prognostic factor for BCR-free survival in all patients or patients with pathologic T2 disease, respectively (p=0.458 and p=0.512). Conclusions FPMs after RP do not significantly affect BCR-free survival in prostate cancer patients.
ISSN:1558-7673
1938-0682
DOI:10.1016/j.clgc.2015.12.013