[Risk factors for positive surgical margins following radical prostatectomy: review]

Ann Urol (Paris). 2006 Dec;40(6):342-8. doi: 10.1016/j.anuro.2006.09.004.
[Article in French]

Abstract

The presence of positive surgical margins on radical prostatectomy specimen is an adverse prognostic factor. Parameters supposed to influence surgical margin status includes pathology method analysis, surgical technique, tumoral and non tumoral patient parameters, and neoadjuvant hormonal therapy. Regarding the surgical technique, surgeon's experience and neuro-vascular bundles preservation are the most important factors of margin status, whereas surgical approach, bladder neck conservation, intraoperative frozen analysis, and bleeding are minor factors. Non tumoural patient parameters influencing surgical margin status include patient's age and weight, and prostate gland weight. For tumoural parameters, pathological stage and tumour volume are more important factors than the tumor grade and PSA. Five preoperative tumoral risk factors of positive surgical margins are particularly important, including abnormal digital rectal examination, preoperative PSA 10 ng/mL, biopsy Gleason score >7, number of positive biopsy cores > or = 2, and suspicion of extraprostatic extension on radical prostatectomy specimen.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Age Factors
  • Biomarkers, Tumor / blood
  • Biopsy, Needle
  • Body Mass Index
  • Digital Rectal Examination
  • Humans
  • Male
  • Neoplasm Recurrence, Local / prevention & control
  • Neoplasm Staging
  • Prognosis
  • Prostate / pathology*
  • Prostate-Specific Antigen / blood
  • Prostatectomy / methods*
  • Prostatic Neoplasms / blood
  • Prostatic Neoplasms / pathology*
  • Prostatic Neoplasms / surgery*
  • Risk Factors

Substances

  • Biomarkers, Tumor
  • Prostate-Specific Antigen