Abstract
Objective: A positive surgical margin (PSM) in the radical prostatectomy (RP) specimen is associated with biochemical recurrence (BCR) and the need for adjuvant radiation therapy, and is a surrogate for surgical quality. We review the available data describing the identification, anatomy, and management of PSM after RP. Methods: A PubMed search (using English language as a filter) was performed to identify factors affecting PSMs and their management. Results: PSMs are associated with an increased likelihood of BCR after RP. The most common location for a PSM is the apex, followed by the posterolateral edge of the prostate. The risk of recurrence in a patient with a PSM is associated with the location, length, and Gleason score of the PSM. The management of a patient with a PSM remains controversial, with some recommending adjuvant radiation therapy for all PSMs and others suggesting only salvage radiation therapy for men who experience BCR. Conclusions: PSMs are associated with an increased likelihood of BCR and often result in initiation of adjuvant treatment. Therefore, the goal of surgery should be to minimize the likelihood of a PSM.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 974-979 |
| Number of pages | 6 |
| Journal | Urologic Oncology: Seminars and Original Investigations |
| Volume | 31 |
| Issue number | 7 |
| DOIs | |
| State | Published - Oct 1 2013 |
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Keywords
- Biochemical recurrence
- Positive surgical margins
- Prostate cancer
- Radical prostatectomy
ASJC Scopus subject areas
- Oncology
- Urology
Cite this
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Radical prostatectomy : Positive surgical margins matter. / Meeks, Joshua J.; Eastham, James A.
In: Urologic Oncology: Seminars and Original Investigations, Vol. 31, No. 7, 01.10.2013, p. 974-979.Research output: Contribution to journal › Review article
TY - JOUR
T1 - Radical prostatectomy
T2 - Positive surgical margins matter
AU - Meeks, Joshua J.
AU - Eastham, James A.
PY - 2013/10/1
Y1 - 2013/10/1
N2 - Objective: A positive surgical margin (PSM) in the radical prostatectomy (RP) specimen is associated with biochemical recurrence (BCR) and the need for adjuvant radiation therapy, and is a surrogate for surgical quality. We review the available data describing the identification, anatomy, and management of PSM after RP. Methods: A PubMed search (using English language as a filter) was performed to identify factors affecting PSMs and their management. Results: PSMs are associated with an increased likelihood of BCR after RP. The most common location for a PSM is the apex, followed by the posterolateral edge of the prostate. The risk of recurrence in a patient with a PSM is associated with the location, length, and Gleason score of the PSM. The management of a patient with a PSM remains controversial, with some recommending adjuvant radiation therapy for all PSMs and others suggesting only salvage radiation therapy for men who experience BCR. Conclusions: PSMs are associated with an increased likelihood of BCR and often result in initiation of adjuvant treatment. Therefore, the goal of surgery should be to minimize the likelihood of a PSM.
AB - Objective: A positive surgical margin (PSM) in the radical prostatectomy (RP) specimen is associated with biochemical recurrence (BCR) and the need for adjuvant radiation therapy, and is a surrogate for surgical quality. We review the available data describing the identification, anatomy, and management of PSM after RP. Methods: A PubMed search (using English language as a filter) was performed to identify factors affecting PSMs and their management. Results: PSMs are associated with an increased likelihood of BCR after RP. The most common location for a PSM is the apex, followed by the posterolateral edge of the prostate. The risk of recurrence in a patient with a PSM is associated with the location, length, and Gleason score of the PSM. The management of a patient with a PSM remains controversial, with some recommending adjuvant radiation therapy for all PSMs and others suggesting only salvage radiation therapy for men who experience BCR. Conclusions: PSMs are associated with an increased likelihood of BCR and often result in initiation of adjuvant treatment. Therefore, the goal of surgery should be to minimize the likelihood of a PSM.
KW - Biochemical recurrence
KW - Positive surgical margins
KW - Prostate cancer
KW - Radical prostatectomy
UR - http://www.scopus.com/inward/record.url?scp=84884669032&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84884669032&partnerID=8YFLogxK
U2 - 10.1016/j.urolonc.2011.12.011
DO - 10.1016/j.urolonc.2011.12.011
M3 - Review article
C2 - 22244265
AN - SCOPUS:84884669032
VL - 31
SP - 974
EP - 979
JO - Urologic Oncology
JF - Urologic Oncology
SN - 1078-1439
IS - 7
ER -