409 IMPACT OF POSITIVE MARGIN ON FROZEN SECTION DURING RADICAL PROSTATECTOMY ON BIOCHEMICAL RECURRENCE

Abstract

You have accessJournal of UrologyProstate Cancer: Staging III1 Apr 2010409 IMPACT OF POSITIVE MARGIN ON FROZEN SECTION DURING RADICAL PROSTATECTOMY ON BIOCHEMICAL RECURRENCE Sejun Park, Taejin Kang, Cheryn Song, and Hanjong Ahn Sejun ParkSejun Park More articles by this author , Taejin KangTaejin Kang More articles by this author , Cheryn SongCheryn Song More articles by this author , and Hanjong AhnHanjong Ahn More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.478AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We evaluated the value of further resection until the frozen sections were negative when positive margin was encountered during radical prostatectomy, on biochemical recurrence (BCR). METHODS Between September 1990 and July 2006, among 585 patients who underwent radical retropubic prostatectomy, we analyzed 55 patients who had cancer at margin on frozen section. We compared BCR rate between 25 patients with further resection until the frozen sections were negative (Group 1, all single margin) and 30 patients without further resection (Group 2). Furthermore, 18 patients in Group 2 with an isolated positive margin (Group 3) were compared to Group 1. RESULTS Mean follow-up after surgery was 39.4 months. Preoperative PSA, surgical Gleason score and pathologic stage were not different between Group 1 and 2. Overall BCR rates were 42.4% in Group 1 and 66.3% in Group 2 (p=0.010). According to the pathologic stage, BCR differences were marginally significant statistically in pT2 (0% vs. 33.3%, p=0.087) but not in pT3 (70.6% vs. 70.8%). Among patients with an isolated positive margin, preoperative PSA, surgical Gleason score and pathologic stage were not different according to whether further resection was done (Group 1 vs. Group 3). Overall BCR in Group 3 was 55.6% (vs. Group 1, p=0.03). In Group 1, none of 8 patients with pT2 had BCR, whereas in Group 3, 2 of 5 pT2 patients (40.0%) had BCR (p=0.042). Similarly, BCR in patients with pT3 disease was not different between Group 1 and Group 3. Location of the positive frozen margin was not associated with BCR. CONCLUSIONS In the cases of positive frozen section margin during radical prostatectomy, performing further resection until the frozen sections were negative reduced biochemical recurrence rate especially in the patients with an isolated margin positive for cancer. However, the benefit was limited to patients with pT2 but not pT3 disease and regardless of the location. Seoul, Republic of Korea© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e162 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sejun Park More articles by this author Taejin Kang More articles by this author Cheryn Song More articles by this author Hanjong Ahn More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...