Key result
A positive surgical margin at prostatectomy occurs in 8.8% to 42% of cases and is associated with a doubled or tripled risk of biochemical (PSA) failure.
Why the study?
Does a positive surgical margin at prostatectomy increase the risk of biochemical (PSA) failure?
Does a positive surgical margin at prostatectomy increase the risk of biochemical (PSA) failure?
Effect estimate: doubled or tripled risk
A positive surgical margin at prostatectomy is a major determinant of biochemical failure, doubling or tripling the risk.
Positive margins may warrant intensified PSA surveillance post-prostatectomy; leaves open whether adjuvant therapy alters outcomes in this observational association.
A positive surgical margin at prostatectomy is defined as tumor cells touching the inked edge of the specimen. This finding is reported in 8.8% to 42% of cases (median about 20%) in various studies. It is one of the main determinants of eventual biochemical (PSA) failure, generally associated with a doubled or tripled risk of failure. The effect of a positive margin on outcome can be modified by stage or grade and the length, number and location of positive margins, as well as by technical operative approach and duration of operator experience. This paper tabulates data from the past decade of studies on margin status.
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Iczkowski et al. (2011) conducted a review in Prostate cancer. Positive surgical margin at prostatectomy was evaluated on Biochemical (PSA) failure (doubled or tripled risk). A positive surgical margin at prostatectomy occurs in 8.8% to 42% of cases and is associated with a doubled or tripled risk of biochemical (PSA) failure.
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