Korean J Urol.  2014 Dec;55(12):802-807. 10.4111/kju.2014.55.12.802.

Location of Positive Surgical Margin and Its Association With Biochemical Recurrence Rate Do Not Differ Significantly in Four Different Types of Radical Prostatectomy

• Suh YS
• Jang HJ
• Song W
• Lee HW
• Kim HS
• Jeon HG
• Jeong BC
• Seo SI
• Jeon SS
• Choi HY
• Lee HM

• KMID: 2070094
• DOI: http://doi.org/10.4111/kju.2014.55.12.802

Abstract

PURPOSE
To analyze the location of the positive surgical margin (PSM) and its association with the biochemical recurrence (BCR) rate in cases of radical prostatectomy (RP) according to the type of surgery.
MATERIALS AND METHODS
We retrospectively analyzed 1,880 cases of RP. Baseline characteristics were analyzed. Locations of the PSM were recorded in the four surgery groups as apex, anterior, posterolateral, and base and were analyzed by using chi-square test. The association of the location of the PSM with the BCR rate was analyzed by using Kaplan-Meier survival analysis according to the type of surgery, which included radical perineal prostatectomy (RPP, n=633), radical retroperitoneal prostatectomy (RRP, n=309), laparoscopic radical prostatectomy (LRP, n=164), and robot-assisted laparoscopic radical prostatectomy (RALRP, n=774).
RESULTS
A PSM was found in a total of 336 cases (18%): 122 cases of RPP (18%), 67 cases of RRP (17%), 29 cases of LRP (17%), and 119 cases of RALRP (15%). The PSM rate did not differ significantly by surgical type (p=0.142). The location of the PSM was the apex in 136 cases (7.2%), anterior in 67 cases (3.5%), posterolateral in 139 cases (7.3%), and base in 95 cases (5.0%), and showed no significant difference according to surgical type (p=0.536, p=0.557, p=0.062, and p=0.109, respectively). The BCR rate according to the location of the PSM did not differ significantly for the four types of surgery (p=0.694, p=0.301, p=0.445, and p=0.309 for RPP, RRP, LRP, and RALRP, respectively).
CONCLUSIONS
The location of the PSM seemed to be unrelated to type of RP. There was no significant correlation between the BCR rate and the location of the PSM for any of the RP types.

Keyword

Operative surgical procedures; Prostate; Prostate neoplasms; Prostatectomy; Recurrence

MeSH Terms

Aged
Humans
Kaplan-Meier Estimate
Laparoscopy/methods
Male
Middle Aged
Neoplasm, Residual/*pathology
Prostate-Specific Antigen/blood
Prostatectomy/*methods
Prostatic Neoplasms/pathology/*surgery
Recurrence
Retrospective Studies
Robotic Surgical Procedures/methods
Prostate-Specific Antigen

Figure

• 

  FIG. 1 Kaplan-Meier survival analysis for BCR-free survival according to the location of the PSM for each type of surgery. BCR, biochemical recurrence; PSM, positive surgical margin; (A) RP, radical prostatectomy; (B) RPP, radical perineal prostatectomy; (C) RRP, radical retroperitoneal prostatectomy; (D) LRP, laparoscopic radical prostatectomy; (E) RALRP, robot-assisted laparoscopic radical prostatectomy.

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