MP83-15 THE IMPACT OF NOT DETERMINABLE SURGICAL MARGINS AFTER RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized IX1 Apr 2015MP83-15 THE IMPACT OF NOT DETERMINABLE SURGICAL MARGINS AFTER RADICAL PROSTATECTOMY Sascha Ahyai, Pierre Tenstedt, Felix Chun, Thorsten Schlomm, Corinna Widmer, Guido Sauter, Hartwig Huland, Markus Graefen, and Derya Tilki Sascha AhyaiSascha Ahyai More articles by this author , Pierre TenstedtPierre Tenstedt More articles by this author , Felix ChunFelix Chun More articles by this author , Thorsten SchlommThorsten Schlomm More articles by this author , Corinna WidmerCorinna Widmer More articles by this author , Guido SauterGuido Sauter More articles by this author , Hartwig HulandHartwig Huland More articles by this author , Markus GraefenMarkus Graefen More articles by this author , and Derya TilkiDerya Tilki More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1890AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Despite meticulous pathological processing and detailed surgeon-pathologist counselling, in some patients the contact of tumor cells with the inked margin of the radical prostatectomy (RP) specimen remains not determinable. To assess and compare the biochemical recurrence (BCR) rate of patients with not determinable (ND), negative (N) and positive (P) surgical margin (SM) after RP. METHODS At the University Medical Center Hamburg-Eppendorf all prostatectomy specimens are inked over their entire surface and processed according to the Stanford Protocol. Patients with positive lymph nodes (pN1) were excluded. Univariable Kaplan-Meier and multivariable Cox regression analyses were used to determine the impact of NDSM on BCR. RESULTS We relied on 8694 (pT2-pT3b, pN0/pNx) consecutive men, who underwent RP between 2008 and 2013 and had complete follow up data. In 7373 (84.1%), 1141 (13.1%) and 180 (2.1%) patients the final pathological report stated NSM, PSM and NDSM, respectively. According to Kaplan Meier analyses there was a statistical significant difference of BCR rate between the three SM groups. NDSM showed the highest BCR rate in patients with pT3a prostate cancer. In a multivariable model after adjusting for preoperative PSA, pathological stage, Gleason score, tumor volume and radiation therapy, SM status remained an independent risk factor for BCR. Both, NDSM (HR=2.1, p<0.001) and PSM (HR 2.1, p<0.001) were significantly associated with an increased risk of BCR when compared to NSM. No significant difference was found between PSM and NDSM status. CONCLUSIONS Although a NDSM is rarely diagnosed by the pathologist, it is independently associated with higher risk of BCR when compared to patients with NSM. Therefore, a NDSM should be considered as a PSM and treated likewise. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e1055 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sascha Ahyai More articles by this author Pierre Tenstedt More articles by this author Felix Chun More articles by this author Thorsten Schlomm More articles by this author Corinna Widmer More articles by this author Guido Sauter More articles by this author Hartwig Huland More articles by this author Markus Graefen More articles by this author Derya Tilki More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...