The role of a positive surgical margin after retropubic radical prostatectomy in prognosis of recurrent prostatic cancer
- Authors: Veliev EI1, Petrov SВ1, Loran ОВ1
-
Affiliations:
- Issue: No 5 (2005)
- Pages: 6-9
- Section: Articles
- URL: https://journals.eco-vector.com/1728-2985/article/view/276586
- ID: 276586
Cite item
Full Text
Abstract
To estimate the occurrence of positive surgical margins (SM) in conduction of radical retropubic prostatectomy and SM role in development of the recurrence, we studied 216 surgical patients with prostatic cancer aged 41 to 73 years. Stages T2a,b, ТЗа, Т1 and T3b were detected in 41.8, 35.6, 18.7 and 3.9% patients, respectively. A positive SM was verified in 68 of 193 (35.2%) patients. Of them, 36 (52.9%) patients had a focal (a single or short SM), while 32 (47.1%) patients had a long SM. The recurrence occurred in 31 (16.1%) cases, primarily in a long SM. In SM-free patients (group 1) one-year survival was 82% being very close to that in group 2 with a focal SM (83%). The differences between the groups were also minimal by three-year survival (75 and 73.6%, respectively). Thus, recurrence-free survival in the focal process and a short SM differs by three-year survival in the groups insignificantly. The period between month 12 and 24 is most risky in respect to recurrences in a short SM. Patients with a long SM had maximal number of prostatic cancer recurrences.
References
- Epstein J. I. Incidence and significance of positive margins in radical prostatectomy specimens. Urol. Clin. N. Am. 1996; 23(4): 651-663.
- Safer M., Hamilton-Nelson K. L., Civantos F., Soloway M. S. Positive surgical margins after radical retropubic prostatectomy: the influence of site and number on progression. J. Urol. (Baltimore) 2002; 167(6): 2453-2456.
- Ayala A. G., Ro J. Y., Babaian R. et al. The prostatic capsule: does it exist? Am. J. Surg. Pathol. 1989; 13(1): 21-27.
- Epstein J. L. Evaluation of radical prostatectomy capsular margins of resection: The significance of margins designated as negative, closely approaching, and positive. Am. J. Surg. Pathol. 1990; 14(3): 621-626.
- Park E. L., Dalkin В., Escobar C., Nagle R. B. Site-specific positive margins at radical prostatectomy: assessing cancer-control benefits of wide excision of the neurovascular bundle on a side with cancer on biopsy. Brit. J. Urol. Int. 2003; 91(3): 219-222.
- Epstein J. I., Carmichael M. J., Pizov G., Walsh P. С Influence of capsular penetration on progression following radical prostatectomy: a study of 196 cases with long-term followup. J. Urol. (Baltimore) 1993; 150(1): 135-141.
Supplementary files
