Is the apical margin real? An analysis of postprostatectomy PSA failure by site of involved margin
| Autor: | Mark Rodacker, James Kyle Russo, Michael Laszewski, Patricia L. Watkins, John M. Watkins |
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| Rok vydání: | 2015 |
| Předmět: | |
| Zdroj: | Journal of Clinical Oncology. 33:105-105 |
| ISSN: | 1527-7755 0732-183X |
| DOI: | 10.1200/jco.2015.33.7_suppl.105 |
| Popis: | 105 Background: Though an involved margin at prostatectomy has been associated with elevated rates of PSA relapse, there has been an absence of consensus regarding the risk of relapse specific to the site(s) of margin involvement. Specifically, the apical margin has been sometimes considered "lower risk," based upon historical series. The present study seeks to determine the rate of PSA relapse in patients who had undergone prostatectomy with involved surgical margin, without immediate post-operative (adjuvant) therapy, with comparison of relapse rates by site of involved margin. Methods: A retrospective database review was performed, including patients with clinically localized prostate cancer and pre-operative PSA 0.2 and rising after prostatectomy. Log-rank analysis was employed for comparison of disease control between groups; the Kaplan-Meier method was employed to construct survival curves and estimate 5-year disease control. Results: Between 2002 and 2010, 155 patients were identified for inclusion in the present analysis. Of these, 105, 37, and 7 patients had 1, 2, and >2 sites of margin involvement, respectively. The apex was the sole site of margin involvement for 70 patients. At a median follow-up of 68 months (range 22-145), 62 patients (40%) had experienced PSA relapse. There was no statistically significant difference in risk of PSA relapse by site of margin involvement or number of foci of margin involvement. The 5-year estimates for PSA relapse for margin involvement of the apex only, other site only, or both were 40.5%, 33%, and 49.1%, respectively. Conclusions: Involvement of the apical margin is associated with a high rate of early PSA relapse, similar to rates noted when other site(s) of margin involvement are noted. |
| Databáze: | OpenAIRE |
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