Non-apical positive surgical margins after radical prostatectomy for pT2 prostate cancer is associated with the highest risk of recurrence
Non-apical positive surgical margins after radical prostatectomy for pT2 prostate cancer is associated with the highest risk of recurrence
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DOI：
10.1002/jso.23573
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发表时间：
2014-06-01
影响因子：
2.5
通讯作者：
Iversen, Peter
中科院分区：
文献类型：
--
作者：
Roder, Martin Andreas;Kawa, Sandra;Iversen, Peter
背景与目的探讨pt2肿瘤手术切缘阳性(PSM)的位置对生化复发(BR)风险的影响。方法自1995年至2011年底连续收治1,133例接受RP治疗的PT2患者。PSM的位置可分为根尖和非根尖。BR定义为Rp后第1次PSA=0.2 ng/ml。用Kaplan-Meier和Cox回归分析BR的危险性。结果中位随访时间为3.6年(0.5~15.5年)。总的pt2 PSM发生率为26.3%。总体而言，患有PSM的pt2患者发生BR的风险是切缘阴性患者的3.1倍。Pt2根尖和非根尖PSM患者的5年生化无复发生存率分别为84.9%(95%CI：77.6-92.2%)和78.6%(95%CI：71.3-85.9%)。在多变量分析中，与切缘阴性患者相比，pt2根尖和非根尖PSM分别导致BR风险增加2.2倍和3.8倍。结论在我们的队列中，pt2 PSM的位置与BR发生的时间相关，也就是说，与根尖PSM相比，非根尖PSM患者BR的风险最高。这可能表明，并不是所有的pt2 PSM患者都应该给予辅助治疗。J·奥科尔外科医生。2014年109：818-822。(C)2014年威利期刊公司。
Background and ObjectiveTo investigate how location of positive surgical margins (PSM) in pT2 tumors affect the risk of biochemical recurrence (BR).MethodsThe study includes 1,133 consecutive patients from 1995 until end of 2011, who had organ-confined disease (pT2) following RP. The location of PSM was stratified into apical and non-apical. BR was defined as the first PSA >= 0.2 ng/ml after RP. Risk of BR was analyzed with Kaplan-Meier and Cox regression analysis.ResultsMedian follow-up was 3.6 years (range: 0.5-15.5 years). The overall pT2 PSM rate was 26.3%. Overall, a pT2 with PSM had a 3.1-fold increased risk of BR compared to margin negative patients. Patients with pT2 apical and non-apical PSM had a 5-year biochemical recurrence-free survival of 84.9% (95% CI: 77.6-92.2%) and 78.6% (95% CI: 71.3-85.9%), respectively. In multivariate analysis, pT2 apical and non-apical PSM was individually associated with a 2.2- and 3.8-fold increased risk of BR compared to margin negative patients.ConclusionIn our cohort the location of pT2 PSM was associated with time to BR, that is, patients with non-apical pT2 PSM endured the highest risk of BR compared to apical PSM. This may indicate that not all patients with pT2 PSM should be offered adjuvant therapy. J. Surg. Oncol. 2014 109:818-822. (c) 2014 Wiley Periodicals, Inc.