The Journal of Urology
Volume 183, Issue 6 , Pages 2213-2218 , June 2010

Positive Surgical Margins at Radical Prostatectomy Predict Prostate Cancer Specific Mortality

  • Jonathan L. Wright

      Affiliations

    • Department of Urology, University of Washington School of Medicine, Seattle, Washington
    • Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
    • Corresponding Author InformationCorrespondence: Department of Urology, University of Washington Medical Center, Health Sciences Building, 1959 NE Pacific, BB-1115, Box 356510, Seattle, Washington 98195 (telephone: 206-543-3640; FAX: 206-543-3272)
    • ,
  • Bruce L. Dalkin

      Affiliations

    • Department of Urology, University of Washington School of Medicine, Seattle, Washington
    • ,
  • Lawrence D. True

      Affiliations

    • Department of Pathology, University of Washington School of Medicine, Seattle, Washington
    • ,
  • William J. Ellis

      Affiliations

    • Department of Urology, University of Washington School of Medicine, Seattle, Washington
    • Financial interest and/or other relationship with Calypso.
    • ,
  • Janet L. Stanford

      Affiliations

    • Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
    • ,
  • Paul H. Lange

      Affiliations

    • Department of Urology, University of Washington School of Medicine, Seattle, Washington
    • ,
  • Daniel W. Lin

      Affiliations

    • Department of Urology, University of Washington School of Medicine, Seattle, Washington
    • Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington

Received 20 October 2009

References 

  1. Cooperberg MR, Pasta DJ, Elkin EP, et al. The University of California, San Francisco Cancer of the Prostate Risk Assessment score: a straightforward and reliable preoperative predictor of disease recurrence after radical prostatectomy. J Urol. 2005;173:1938
  2. Eggener SE, Vickers AJ, Serio AM, et al. Comparison of models to predict clinical failure after radical prostatectomy. Cancer. 2009;115:303
  3. Freedland SJ, Amling CL, Dorey F, 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
  4. Stephenson AJ, Scardino PT, Eastham JA, et al. Postoperative nomogram predicting the 10-year probability of prostate cancer recurrence after radical prostatectomy. J Clin Oncol. 2005;23:7005
  5. Suardi N, Porter CR, Reuther AM, et al. A nomogram predicting long-term biochemical recurrence after radical prostatectomy. Cancer. 2008;112:1254
  6. Walz J, Chun FK, Klein EA, et al. Nomogram predicting the probability of early recurrence after radical prostatectomy for prostate cancer. J Urol. 2009;181:601
  7. Makarov DV, Trock BJ, Humphreys EB, et al. Updated nomogram to predict pathologic stage of prostate cancer given prostate-specific antigen level, clinical stage, and biopsy Gleason score (Partin tables) based on cases from 2000 to 2005. Urology. 2007;69:1095
  8. Ohori M, Kattan MW, Koh H, et al. Predicting the presence and side of extracapsular extension: a nomogram for staging prostate cancer. J Urol. 2004;171:1844
  9. Simon MA, Kim S, Soloway MS. Prostate specific antigen recurrence rates are low after radical retropubic prostatectomy and positive margins. J Urol. 2006;175:140
  10. Karakiewicz PI, Eastham JA, Graefen M, et al. Prognostic impact of positive surgical margins in surgically treated prostate cancer: multi-institutional assessment of 5831 patients. Urology. 2005;66:1245
  11. Pettus JA, Weight CJ, Thompson CJ, et al. Biochemical failure in men following radical retropubic prostatectomy: impact of surgical margin status and location. J Urol. 2004;172:129
  12. Swindle P, Eastham JA, Ohori M, et al. Do margins matter? (The prognostic significance of positive surgical margins in radical prostatectomy specimens). J Urol. 2005;174:903
  13. Ward JF, Zincke H, Bergstralh EJ, et al. The impact of surgical approach (nerve bundle preservation versus wide local excision) on surgical margins and biochemical recurrence following radical prostatectomy. J Urol. 2004;172:1328
  14. Pfitzenmaier J, Pahernik S, Tremmel T, et al. Positive surgical margins after radical prostatectomy: do they have an impact on biochemical or clinical progression?. BJU Int. 2008;102:1413
  15. Collette L. Prostate-specific antigen (PSA) as a surrogate end point for survival in prostate cancer clinical trials. Eur Urol. 2008;53:6
  16. Stephenson AJ, Kattan MW, Eastham JA, et al. Defining biochemical recurrence of prostate cancer after radical prostatectomy: a proposal for a standardized definition. J Clin Oncol. 2006;24:3973
  17. D'Amico AV, Moul J, Carroll PR, et al. Surrogate end point for prostate cancer specific mortality in patients with nonmetastatic hormone refractory prostate cancer. J Urol. 2005;173:1572
  18. Freedland SJ, Humphreys EB, Mangold LA, et al. Risk of prostate cancer-specific mortality following biochemical recurrence after radical prostatectomy. JAMA. 2005;294(433-):9
  19. Surveillance, Epidemiology, and End Results (SEER) Program Populations (1969–2005), National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch. www.seer.cancer.gov/popdata
  20. Bill-Axelson A, Holmberg L, Ruutu M, et al. Radical prostatectomy versus watchful waiting in early prostate cancer. N Engl J Med. 2005;352:1977
  21. Evans AJ, Henry PC, Van der Kwast TH, et al. Interobserver variability between expert urologic pathologists for extraprostatic extension and surgical margin status in radical prostatectomy specimens. Am J Surg Pathol. 2008;32:1503
  22. Sehdev AE, Pan CC, Epstein JI. Comparative analysis of sampling methods for grossing radical prostatectomy specimens performed for nonpalpable (stage T1c) prostatic adenocarcinoma. Hum Pathol. 2001;32:494
  23. Garcia JJ, Al-Ahmadie HA, Gopalan A, et al. Do prostatic transition zone tumors have a distinct morphology?. Am J Surg Pathol. 2008;32:1709
  24. Van der Kwast TH, Bolla M, Van Poppel H, et al. Identification of patients with prostate cancer who benefit from immediate postoperative radiotherapy: EORTC 22911. J Clin Oncol. 2007;25:4178
  25. Eastham JA, Kuroiwa K, Ohori M, et al. Prognostic significance of location of positive margins in radical prostatectomy specimens. Urology. 2007;70:965
  26. Obek C, Sadek S, Lai S, et al. Positive surgical margins with radical retropubic prostatectomy: anatomic site-specific pathologic analysis and impact on prognosis. Urology. 1999;54:682
  27. Yossepowitch O, Bjartell A, Eastham JA, et al. Positive surgical margins in radical prostatectomy: outlining the problem and its long-term consequences. Eur Urol. 2009;55:87

 Supported by National Institutes of Health Grant T32 CA009168-30 and the Fred Hutchinson Cancer Research Center.

 See Editorial on page 2126.

PII: S0022-5347(10)00258-2

doi: 10.1016/j.juro.2010.02.017

The Journal of Urology
Volume 183, Issue 6 , Pages 2213-2218 , June 2010

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