Prognostic implications of a positive apical margin in radical prostatectomy specimens

被引:83
作者
Fesseha, T [1 ]
Sakr, W [1 ]
Grignon, D [1 ]
Banerjee, M [1 ]
Wood, DP [1 ]
Pontes, JE [1 ]
机构
[1] WAYNE STATE UNIV,DEPT PATHOL,DETROIT,MI 48202
关键词
prostate; prostatic neoplasms; prostatectomy; prostate-specific antigen;
D O I
10.1016/S0022-5347(01)68189-8
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose: We evaluated the prognostic implication of a positive surgical margin at the prostatic apex to define the risk of failure after radical prostatectomy. Materials and Methods: Radical prostatectomy specimens of 590 patients operated on between 1990 and 1994 were reviewed by 2 uropathologists (D. G. and W. S.) to determine the percentage of patients with a positive margin at the apex in the absence of positive margins, extraprostatic extension or involvement of seminal vesicles and pelvic lymph nodes. In this group of 33 patients, the significance of a positive apex could be determined without the influence of any other stage related prognostic factors. Treatment failure was defined as prostate specific antigen greater than 0.4. All 33 patients have been followed between 3.5 and 65.5 months (median 38.7). Results: Among 590 patients 236 (40%) had disease completely confined to the prostate. A total of 217 patients (37%) had either positive surgical margins (M+) or extraprostatic extension and of these, only 33 (5.5%) had an apical positive margin in an otherwise prostate confined tumor. Of 33 apical positive margin patients only 3 in whom surgery failed had progressively detectable prostate specific antigen 3.5 to 65.5 months after surgery. Conclusions: A positive surgical margin at the prostatic apex in the absence of positive margins or extraprostatic extension elsewhere does not confer a worse prognosis than organ confined disease. In this study the recurrence rate for patients with positive apical margins was the same as for those with confined disease.
引用
收藏
页码:2176 / 2179
页数:4
相关论文
共 27 条
[11]   PROSTATE SHAPE, EXTERNAL STRIATED URETHRAL SPHINCTER AND RADICAL PROSTATECTOMY - THE APICAL DISSECTION [J].
MYERS, RP ;
GOELLNER, JR ;
CAHILL, DR .
JOURNAL OF UROLOGY, 1987, 138 (03) :543-550
[12]   PROGNOSTIC-SIGNIFICANCE OF POSITIVE SURGICAL MARGINS IN RADICAL PROSTATECTOMY SPECIMENS [J].
OHORI, M ;
WHEELER, TM ;
KATTAN, MW ;
GOTO, Y ;
SCARDINO, PT .
JOURNAL OF UROLOGY, 1995, 154 (05) :1818-1824
[13]   INFLUENCE OF WIDE EXCISION OF THE NEUROVASCULAR BUNDLE(S) ON PROGNOSIS IN MEN WITH CLINICALLY LOCALIZED PROSTATE-CANCER WITH ESTABLISHED CAPSULAR PENETRATION [J].
PARTIN, AW ;
BORLAND, RN ;
EPSTEIN, JI ;
BRENDLER, CB .
JOURNAL OF UROLOGY, 1993, 150 (01) :142-146
[14]  
PARTIN AW, 1993, UROL CLIN N AM, V20, P713
[15]   RADICAL PROSTATECTOMY - ANATOMICAL PREDICTORS OF SUCCESS OR FAILURE [J].
PAULSON, DF ;
STONE, AR ;
WALTHER, PJ ;
TUCKER, JA ;
COX, EB .
JOURNAL OF UROLOGY, 1986, 136 (05) :1041-1043
[16]   COMPARISON OF MAGNETIC-RESONANCE-IMAGING AND ULTRASONOGRAPHY IN STAGING EARLY PROSTATE-CANCER - RESULTS OF A MULTIINSTITUTIONAL COOPERATIVE TRIAL [J].
RIFKIN, MD ;
ZERHOUNI, EA ;
GATSONIS, CA ;
QUINT, LE ;
PAUSHTER, DM ;
EPSTEIN, JI ;
HAMPER, U ;
WALSH, PC ;
MCNEIL, BJ .
NEW ENGLAND JOURNAL OF MEDICINE, 1990, 323 (10) :621-626
[17]   FREQUENCY AND LOCATION OF EXTRACAPSULAR EXTENSION AND POSITIVE SURGICAL MARGINS IN RADICAL PROSTATECTOMY SPECIMENS [J].
ROSEN, MA ;
GOLDSTONE, L ;
LAPIN, S ;
WHEELER, T ;
SCARDINO, PT .
JOURNAL OF UROLOGY, 1992, 148 (02) :331-337
[18]  
Sakr WA, 1995, J UROL PATHOL, V3, P355
[19]  
STAMEY TA, 1990, J UROLOGY, V143, P1166
[20]   PROSTATE SPECIFIC ANTIGEN IN THE DIAGNOSIS AND TREATMENT OF ADENOCARCINOMA OF THE PROSTATE .4. ANTI-ANDROGEN TREATED PATIENTS [J].
STAMEY, TA ;
KABALIN, JN ;
FERRARI, M ;
YANG, N .
JOURNAL OF UROLOGY, 1989, 141 (05) :1088-1090