Reporting positive surgical margins after radical prostatectomy: time for standardization

Area of Science:

• Urology
• Surgical Pathology
• Oncology

Background:

• Positive surgical margins (PSMs) after radical prostatectomy (RP) are critical indicators of potential cancer recurrence.
• Current literature lacks consistent reporting on PSM characteristics and their prognostic significance.

Purpose of the Study:

• To assess reporting consistency of PSMs and associated prognostic variables after RP.
• To propose a standardized methodology for quantifying PSM characteristics and their prognostic impact.

Main Methods:

• A systematic review of 44 studies published from January 2005 onwards was conducted.
• Studies were assessed for reporting quality based on six defined criteria from the College of American Pathologists and International Society of Uropathologists guidelines.
• The prognostic value of PSM characteristics on biochemical recurrence (BCR) was analyzed.

Main Results:

• Only the definition of a PSM was consistently reported across all 44 studies.
• Significant inconsistencies were found in reporting PSM site, length, and intraprostatic incision.
• Conflicting reports limited the understanding of the true significance of PSM variables on BCR.

Conclusions:

• Inconsistent reporting of PSMs and associated prognostic variables hinders accurate interpretation of their impact.
• A lack of standardized reporting methodology is a primary contributor to these inconsistencies.
• Implementing a standardized scoring system for PSMs is recommended to improve future reporting and analysis.