The Journal of Urology
Volume 179, Issue 5 , Pages 1791-1796 , May 2008

Risk Stratification for Biochemical Recurrence in Men With Positive Surgical Margins or Extracapsular Disease After Radical Prostatectomy: Results From the SEARCH Database

  • Jayakrishnan Jayachandran

      Affiliations

    • Division of Urologic Surgery, Departments of Surgery and Pathology and Duke Prostate Center, Duke University School of Medicine, Durham, North Carolina
    • Urology Section, Veterans Affairs Medical Center Durham, Durham, North Carolina
    • ,
  • Lionel L. Bañez

      Affiliations

    • Division of Urologic Surgery, Departments of Surgery and Pathology and Duke Prostate Center, Duke University School of Medicine, Durham, North Carolina
    • Urology Section, Veterans Affairs Medical Center Durham, Durham, North Carolina
    • ,
  • Donna E. Levy

      Affiliations

    • Division of Urologic Surgery, Departments of Surgery and Pathology and Duke Prostate Center, Duke University School of Medicine, Durham, North Carolina
    • ,
  • William J. Aronson

      Affiliations

    • Urology Section, Veterans Affairs Greater Los Angeles Healthcare System, Department of Urology, University of California-Los Angeles School of Medicine, Los Angeles, California
    • ,
  • Martha K. Terris

      Affiliations

    • Urology Section, Veterans Affairs Medical Center Augusta and Section of Urology, Medical College of Georgia, Augusta, Georgia
    • ,
  • Joseph C. Presti Jr.

      Affiliations

    • Department of Urology, Stanford University School of Medicine and Urology Section, Veterans Affairs Medical Center Palo Alto, Palo Alto, California
    • ,
  • Christopher L. Amling

      Affiliations

    • Department of Urology, University of Alabama Birmingham, Birmingham, Alabama
    • ,
  • Christopher J. Kane

      Affiliations

    • Urology Section, Veterans Affairs Medical Center San Francisco and Department of Urology, University of California, San Francisco School of Medicine, San Francisco, California
    • ,
  • Stephen J. Freedland

      Affiliations

    • Division of Urologic Surgery, Departments of Surgery and Pathology and Duke Prostate Center, Duke University School of Medicine, Durham, North Carolina
    • Urology Section, Veterans Affairs Medical Center Durham, Durham, North Carolina
    • Corresponding Author InformationCorrespondence and requests for reprints: Division of Urology, Box 2626 DUMC, Duke University School of Medicine, Durham, North Carolina 27710 (telephone: 919-668-8361; FAX: 919-668-7093).
    • ,
  • SEARCH Database Study Group

Received 14 September 2007

References 

  1. Han M, Partin AW, Pound CR, Epstein JI, Walsh PC. Long-term biochemical disease-free and cancer-specific survival following anatomic radical retropubic prostatectomy: the 15-year Johns Hopkins experience. Urol Clin North Am. 2001;28:555
  2. Roehl KA, Han M, Ramos CG, Antenor JAV, Catalona WJ. Cancer progression and survival rates following anatomical radical retropubic prostatectomy in 3,478 consecutive patients: long-term results. J Urol. 2004;172:910
  3. D’Amico AV, Whittington R, Malkowicz SB, Schultz D, Schnall M, Tomaszewski JE, et al. A multivariate analysis of clinical and pathological factors that predict for prostate specific antigen failure after radical prostatectomy for prostate cancer. J Urol. 1995;154:131
  4. Messing EM, Manola J, Sarosdy M, Wilding G, Crawford ED, Trump D. Immediate hormonal therapy compared with observation after radical prostatectomy and pelvic lymphadenectomy in men with node-positive prostate cancer. N Engl J Med. 1999;341:1781
  5. Thompson IM, Tangen CM, Paradelo J, Lucia MS, Miller G, Troyer D, et al. Adjuvant radiotherapy for pathologically advanced prostate cancer: a randomized clinical trial. JAMA. 2006;296:2329
  6. Bolla M, van Poppel H, Collette L, van Cangh P, Vekemans K, Da Pozzo L, et al. Postoperative radiotherapy after radical prostatectomy: a randomised controlled trial (EORTC trial 22911). Lancet. 2005;366:572
  7. Freedland SJ, Amling CL, Dorey F, Kane CJ, Presti JC, Terris MK, et al. Race as an outcome predictor after radical prostatectomy: results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database. Urology. 2002;60:670
  8. Stephenson AJ, Scardino PT, Eastham JA, Bianco FJ, Dotan ZA, DiBlasio CJ, et al. Postoperative nomogram predicting the 10-year probability of prostate cancer recurrence after radical prostatectomy. J Clin Oncol. 2005;23:7005
  9. Harrell FE, Califf RM, Pryor DB, Lee KL, Rosati RA. Evaluating the yield of medical tests. JAMA. 1982;247:2543
  10. Karakiewicz PI, Eastham JA, Graefen M, Cagiannos I, Stricker PD, Klein E, et al. Prognostic impact of positive surgical margins in surgically treated prostate cancer: multi-institutional assessment of 5831 patients. Urology. 2005;66:1245
  11. Partin AW, Piantadosi S, Sanda MG, Epstein JI, Marshall FF, Mohler JL, et al. Selection of men at high risk for disease recurrence for experimental adjuvant therapy following radical prostatectomy. Urology. 1995;45:831
  12. Bauer JJ, Connelly RR, Seterhenn IA, Deausen J, Srivastava S, McLeod DG, et al. Biostatistical modeling using traditional preoperative and pathological prognostic variables in the selection of men at high risk for disease recurrence after radical prostatectomy for prostate cancer. J Urol. 1998;159:929
  13. Epstein JI. Incidence and significance of positive margins in radical prostatectomy specimens. Urol Clin North Am. 1996;23:651
  14. Lowe BA, Lieberman SF. Disease recurrence and progression in untreated pathologic stage t3 prostate cancer: selecting the patient for adjuvant therapy. J Urol. 1997;158:1452
  15. Obek C, Sadek S, Lai S, Civantos F, Rubinowicz D, Soloway MS. Positive surgical margins with radical retropubic prostatectomy: anatomic site-specific pathologic analysis and impact on prognosis. Urology. 1999;54:682
  16. Khan MA, Han M, Partin AW, Epstein JI, Walsh PC. Long-term cancer control of radical prostatectomy in men younger than 50 years of age: update 2003. Urology. 2003;62:86
  17. Freedland SJ, Presti JC, Kane CJ, Aronson WJ, Terris MK, Dorey F, et al. Do younger men have better biochemical outcomes after radical prostatectomy?. Urology. 2004;63:518
  18. Freedland SJ, Isaacs WB, Platz EA, Terris MK, Aronson WJ, Amling CL, et al. Prostate size and risk of high-grade, advanced prostate cancer and biochemical progression after radical prostatectomy: a search database study. J Clin Oncol. 2005;23:7546
  19. D’Amico AV, Whittington R, Malkowicz SB, Schultz D, Tomaszewski JE, Wein A. A prostate gland volume of more than 75 cm3 predicts for a favorable outcome after radical prostatectomy for localized prostate cancer. Urology. 1998;52:631
  20. Freedland SJ, Humphreys EB, Mangold LA, Eisenberger M, Partin AW. Time to prostate specific antigen recurrence after radical prostatectomy and risk of prostate cancer specific mortality. J Urol. 2006;176:1404

 Study received institutional review board approval from each institution.

 Supported by the Department of Veterans Affairs, National Institutes of Health R01CA100938 (WJA), National Institutes of Health Specialized Programs of Research Excellence Grant P50 CA92131-01A1 (WJA), Georgia Cancer Coalition (MKT), Department of Defense Prostate Cancer Research Program (SJF) and an American Urological Association Foundation/Astellas Rising Star in Urology Award (SJF).

 Views and opinions of and endorsements by the author(s) do not reflect those of the United States Army or the Department of Defense.

PII: S0022-5347(08)00049-9

doi: 10.1016/j.juro.2008.01.043

The Journal of Urology
Volume 179, Issue 5 , Pages 1791-1796 , May 2008

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