You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy V1 Apr 2017MP64-18 LONG-TERM IMPACT OF POSITIVE SURGICAL MARGINS AFTER RADICAL PROSTATECTOMY: AN ANALYSIS OF A LARGE PROSPECTIVE COHORT Joanne Nyarangi-Dix, Gencay Hatiboglu, Dogu Teber, Stefan Duensing, and Markus Hohenfellner Joanne Nyarangi-DixJoanne Nyarangi-Dix More articles by this author , Gencay HatibogluGencay Hatiboglu More articles by this author , Dogu TeberDogu Teber More articles by this author , Stefan DuensingStefan Duensing More articles by this author , and Markus HohenfellnerMarkus Hohenfellner More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1991AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Management of prostate cancer is complicated by positive surgical margins (PSM) after prostatectomy. We present risk factors for and impact of PSM in a large prospective cohort. METHODS The Heidelberg prospective tumour data base was searched data on PSM including Gleason pattern of PSM, age, BMI, preop.-PSA, Gleason score(GS), Specimen T- and N-stage, PSA up to 10 yrs. after RP etc. RT regime and HT were considered. Recurrence free(RFS) and cancer specific survival(CSS) were evaluated. Analysis was made with the IBM-SPSS software and Chi2-, Students'- t-test and Fischer's test, Kaplan meier and multivariate analyses. RESULTS 2383 men were investigated. Approx. 45% had locally advanced disease and 44% had PSM. Significantly higher PSM rates were noted in men with suspicious digital-rectal examination (DRE), pT>2, GS>7 and preop.-PSA>10ng/ml. PSM-rate was also significantly influenced by the surgeon and BMI>25. PT>2, suspicious DRE and preop. PSA>10ng/ml were associated with Gleason-pattern >3 at PSM. Gleason-pattern at PSM did not influence postop. PSA. PSM significantly influenced biochemical recurrence (BCR). Men with PSM had significantly higher PSA at 3, 6, 12, 24, 36, 48 and 60 months. The chance of BCR at 3, 6, 12 and 24 months significantly correlated to preop. PSA. Multivariate analyses revealed significantly higher PSMs only in pT>2 (p<0.001), GS>7(p=0.001), preop. PSA>10ng/ml(p<0.001), BMI>25(p=0.02) and suspicious DRE(p=0.05). Preop. PSA significantly correlated to pT>2 (p<0.001), GS>7(p=0.001), pN+(p=0.001), PSM(p<0.001), and BCR(p=0.05) in the multivariate analysis. 24% received RT; significantly more men with PSM(p<0.001) or GS>7(p<0.001) received RT. pT-stage, GS, PSM and pattern at PSM (à p<0.001) influenced RT-regime significantly. BCR at 12(p<0.001) months was significantly lower after ART; there was no significant correlation between RT-regime and BCR afterwards. RDE(p=0.02), ECOG-Score(p=0.02), pT-stage(p<0.001), GS(p<0.001), PSM (p=0.01) significantly affected CSS. RFS was significantly influenced by pT-stage(p<0.001), PSM(p=0.001), GS (p=0.002), preop. PSA(p<0.001) and suspicious DRE(p=0.001) in the multivariate investigation CONCLUSIONS Aggressive tumour specific characteristics like preop. PSA>10, pT>2 and GS>7 and BMI significantly increased risk for PSM. PSM also considerably influenced BCR. These results underline the importance of early cancer detection enabling prompt therapy. Techniques to reduce PSM-rate especially in advanced prostate cancer should be concurrently explored. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e851 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Joanne Nyarangi-Dix More articles by this author Gencay Hatiboglu More articles by this author Dogu Teber More articles by this author Stefan Duensing More articles by this author Markus Hohenfellner More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...