Positive surgical margins after radical retropubic prostatectomy

The influence of site and number on progression

Mario Sofer, Kara L. Hamilton-Nelson, Francisco Civantos, Mark S. Soloway

Research output: Contribution to journalArticle

112 Citations (Scopus)

Abstract

Purpose: We assessed the effect of location and number of positive margins on biochemical progression in patients after radical retropubic prostatectomy for prostate cancer. Materials and Methods: The incidence, location and number of positive surgical margins as well as recurrence and time to recurrence were evaluated in a consecutive series of 734 men who underwent radical retropubic prostatectomy for localized prostate cancer from 1992 through February 1999. Results: Surgical margins were positive in 210 patients (29%), of whom 157 (75%) and 53 (25%) had 1 and more than 1 positive margin, respectively. Of the patients 53 (25%) with tumor at any inked margin had biochemical recurrence. We identified no significant association of a particular location with biochemical recurrence. Bladder neck location did not carry an increased risk of recurrence (hazard ratio 1.23, 95% confidence interval 0.54 to 2.80). However, these findings were made in a limited number of cases with positive bladder neck margins. Patients with more than 1 positive surgical margin were at increased risk for recurrence compared with those with a single positive surgical margin (hazard ratio 2.19, 95% confidence interval 1.11 to 4.32). In addition, prostate specific antigen greater than 20 ng./ml. and seminal vesicle invasion were significant predictors of progression. Conclusions: In patients with localized prostate cancer and positive surgical margins biochemical progression is not dictated by the specific location of a positive margin. However, multiple positive margins are associated with a significantly increased risk of biochemical recurrence. Longer followup and larger sample size are necessary to confirm these findings.

Original languageEnglish
Pages (from-to)2453-2456
Number of pages4
JournalJournal of Urology
Volume167
Issue number6
StatePublished - May 30 2002

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Prostatectomy
Recurrence
Prostatic Neoplasms
Urinary Bladder
Confidence Intervals
Seminal Vesicles
Prostate-Specific Antigen
Margins of Excision
Sample Size
Incidence
Neoplasms

Keywords

  • Disease progression
  • Prostate
  • Prostate-specific antigen
  • Prostatectomy
  • Prostatic neoplasms

ASJC Scopus subject areas

  • Urology

Cite this

Positive surgical margins after radical retropubic prostatectomy : The influence of site and number on progression. / Sofer, Mario; Hamilton-Nelson, Kara L.; Civantos, Francisco; Soloway, Mark S.

In: Journal of Urology, Vol. 167, No. 6, 30.05.2002, p. 2453-2456.

Research output: Contribution to journalArticle

Sofer, Mario ; Hamilton-Nelson, Kara L. ; Civantos, Francisco ; Soloway, Mark S. / Positive surgical margins after radical retropubic prostatectomy : The influence of site and number on progression. In: Journal of Urology. 2002 ; Vol. 167, No. 6. pp. 2453-2456.
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