MADRID, SPAIN (UroToday.com) - Positive surgical margin (PSM) is thought to impact biochemical recurrence. The aim of this study was to assess the influence of the Gleason score (GS) at the level of positive surgical margin on biochemical recurrence.
The group conducted a retrospective study on a prospectively maintained clinical database including all radical prostatectomies (n = 658) performed between January 2007 to November 2011. A total of 106 (16%) had positive surgical margins. The prostatectomy specimens with positive surgical margins were reviewed to determine the Gleason score at the level of positive surgical margins.
Five patients with positive surgical margins were excluded: 2 for premature death not related to prostate cancer, 1 for lack of histology available on pathology re-review, and 2 for negative surgical margins after reviewing the slides. With a mean follow-up of 38 months (range 24 to 84), biochemical recurrence was reported in 32 patients (BRR = 31.7%). Gleason score at the margin was 6 in 55 cases, 3+4 in 28, 4+3 in 8, and > 7 in 10. Gleason score at margin was significantly associated with biochemical relapse rate (p = 0.008). On a univariate analysis, GS at margin was predictor of biochemical recurrence in addition to initial PSA, final pathological Gleason Score, length of positive surgical margin, and seminal vesicle invasion. On multivariate analysis, PSA > 10 and length of PSM > 3mm were independent predictors of biochemical recurrence.
The group concluded that Gleason score at the level of positive surgical margin was a predictor of biochemical recurrence in univariate but not in multivariate analysis. Longer follow-up or a larger patient population could improve the power of this study to detect the true impact of Gleason score at the margins.
Presented by Susperregui J.,1 Pierry C.,2 Bonhomme B.,2 Pasticier G.,1 Bernhard J-C.,1 Yacoub M.,2 Karavitakis M.,3 Ballanger P.,1 Ferrière J-M.,1 and Robert G.Y.1 at the 30th Annual European Association of Urology (EAU) Congress - March 20 - 24, 2015 - IFEMA - Feria de Madrid - Madrid, Spain
1Bordeaux Pellegrin University Hospital, Dept. of Urology, Bordeaux, 2Bordeaux Pellegrin University Hospital, Dept. of Pathology, Bordeaux, 3Bordeaux Pellegrin University Hospital, Dept. of Biostatistics and Epidemiology, Bordeaux
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Reported by Mohammed Haseebuddin, MD, medical writer for UroToday.com