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The relationship between the extent of surgical margin positivity and prostate specific antigen recurrence in radical prostatectomy specimens.
- Source :
-
Human pathology [Hum Pathol] 2007 Aug; Vol. 38 (8), pp. 1207-11. Date of Electronic Publication: 2007 May 08. - Publication Year :
- 2007
-
Abstract
- The presence of positive surgical margins is a negative prognostic indicator in patients undergoing prostatectomy for prostate cancer; whether the extent of the positive margins affects the clinical outcome with regards to prostate-specific antigen (PSA) recurrence remains uncertain. We evaluated the linear extent of margin positivity as a prognostic indicator in a series of radical prostatectomy specimens. One hundred seventy-four consecutive margin-positive prostatectomy specimens were evaluated. The linear extent of margin positivity was measured with an ocular micrometer and ranged from 0.05 to 75.0 mm (mean, 8.94; median, 5.0). The linear extent of margin positivity was associated with tumor volume (P = .03) but was not associated with patients' age at surgery, preoperative PSA level, prostate weight, pathologic stage, Gleason score, extraprostatic extension, seminal vesicle invasion, perineural invasion, high-grade prostatic intraepithelial neoplasia, or PSA recurrence. In the full model multiple Cox regression, significant predictors for PSA recurrence were Gleason score (P = .001) and preoperative PSA (P = .01); extent of margin positivity was not predictive of PSA recurrence (hazard ratio, 1.00; 95% confidence interval, 0.98-1.02; P = .97) nor was tumor volume a significant factor when adjusted for other covariates (P = .27). Preoperative PSA, tumor stage, and Gleason score remained significant prognostic factors in evaluating the likelihood of PSA recurrence in patients with positive surgical margins; the extent of margin positivity, however, is not a prognostic factor for PSA recurrence and should, therefore, not necessarily be included in the final report for radical prostatectomy specimens.
- Subjects :
- Adenocarcinoma blood
Adenocarcinoma surgery
Humans
Male
Middle Aged
Neoplasm Invasiveness
Neoplasm Recurrence, Local blood
Neoplasm, Residual
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Prostatic Neoplasms blood
Prostatic Neoplasms surgery
Adenocarcinoma pathology
Neoplasm Recurrence, Local pathology
Prostate-Specific Antigen blood
Prostatectomy
Prostatic Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 0046-8177
- Volume :
- 38
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Human pathology
- Publication Type :
- Academic Journal
- Accession number :
- 17490720
- Full Text :
- https://doi.org/10.1016/j.humpath.2007.01.006