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J Susperregui1, C Pierry2, B Bonhomme2

  • 1Service d'urologie, centre hospitalier universitaire de Bordeaux, place Amélie-Raba-Léon, 33000 Bordeaux, France.

Progres En Urologie : Journal De L'Association Francaise D'Urologie Et De La Societe Francaise D'Urologie
|September 5, 2017
PubMed
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Gleason score at positive surgical margins (PSM) did not independently predict biochemical recurrence after prostatectomy. Initial PSA and PSM length were the only significant predictors of recurrence.

Area of Science:

  • Urology
  • Oncology
  • Pathology

Background:

  • Positive surgical margins (PSM) after radical prostatectomy (RP) indicate residual cancer.
  • Assessing the aggressiveness of cancer at PSM is crucial for predicting recurrence.

Purpose of the Study:

  • To evaluate the impact of Gleason score (GS) at the level of PSM on biochemical recurrence rate (BRR) after RP.

Main Methods:

  • Retrospective analysis of 658 RP procedures (2007-2011).
  • Review of RP specimens with PSM to determine GS at the margin.
  • Comparison of GS at PSM with BRR, with univariate and multivariate analyses.

Main Results:

  • 16% of RPs had PSM; 101 patients with PSM were analyzed.
Keywords:
Biochemical recurrenceCancer de ProstateGleason scoreMarges chirurgicales positivePositive surgical marginProstate cancerProstatectomie totaleRadical prostatectomyRécidive biologiqueScore de Gleason

Related Experiment Videos

  • 32% of patients with PSM experienced biochemical recurrence (BR).
  • Univariate analysis showed GS at PSM, initial PSA, pathologic GS, PSM length, and seminal vesicle invasion predicted BR. Multivariate analysis identified PSA > 10ng/mL and PSM length > 3mm as independent predictors, but not GS at PSM.

    • Conclusions:

    • Gleason score at the positive surgical margin is not an independent predictor of biochemical recurrence.
    • Initial PSA and positive surgical margin length are the primary independent prognostic factors for biochemical recurrence following radical prostatectomy.