Abstract
To investigate the effect of the distance between tumor and surgical margin on biochemical recurrence in patients with organ-confined prostate cancer. The data of 208 patients, who underwent radical prostatectomy between 2012-2018, were retrospectively analyzed. The surgical margin status of 147 pathologically organ-confined patients was categorized as positive, close ( < 1mm) and negative. Surgical margin status and parameters affecting biochemical recurrence were examined. Furthermore, multivariate analysis was done to determine the parameters associated with biochemical recurrence. Biochemical recurrence was detected in 21 (14.2%) of 147 patients. 38 (27.9%) men had negative surgical margins, 68 (46.2%) had close surgical margins and 41 (25.9%) had positive surgical margins. Tumor volume and ISUP grade were found to be statistically significant for positive surgical margin and close surgical margin patients compared to negative surgical margin patients. Close surgical margin was not statistically associated with biochemical recurrence. Preoperative high PSA (p < 0.001) and positive surgical margin (p=0.021) were independent risk factors for biochemical recurrence. According to our results, it is not necessary to include the presence of a close surgical margin in the pathology reports in patients with pathological organ-confined tumors and negative surgical margins.
Highlights
Biochemical recurrence (BCR), which is one of the important markers in predicting prognosis following radical prostatectomy, is associated with various factors, and surgical margin positivity is one of the leading ones
BCR in cases with localized prostate carcinoma, where the positive surgical margin is not observed, suggests that the tumor’s contact with the surgical margin and its proximity may affect the development of recurrence [4,5,6,7]
It was observed that the patients in the positive surgical margin (PSM) and close surgical margin (CSM) groups had higher International Society of Urological Pathology (ISUP) grade compared to the patients in the negative surgical margins (NSM) group (p=0.004)
Summary
Biochemical recurrence (BCR), which is one of the important markers in predicting prognosis following radical prostatectomy, is associated with various factors, and surgical margin positivity is one of the leading ones. BCR in cases with localized prostate carcinoma, where the positive surgical margin is not observed, suggests that the tumor’s contact with the surgical margin and its proximity may affect the development of recurrence [4,5,6,7]. The cut-off values taken for the definition of the tumor’s proximity to the surgical margin vary and the effect of this factor on biochemical recurrence remains unclear
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