Prognostic significance of positive surgical margins in radical prostatectomy specimens.
OBJECTIVE
The prognostic significance of positive surgical margins in radical prostatectomy specimens was assessed.


METHODS
The interval to progression (increasing prostate specific antigen level) was measured in 478 patients by status of the surgical margins.


RESULTS
At 5 years, the nonprogression rate was 64% for patients with and 83% for those without positive surgical margins. With a high grade cancer, seminal vesicle invasion or lymph node metastases, positive surgical margins had no effect on prognosis; with extracapsular extension and a Gleason score of 6 or less positive surgical margins were associated with a higher progression rate.


CONCLUSIONS
Prognosis was adversely affected by positive surgical margins only in moderately differentiated cancers with extracapsular extension alone. If the cancer is otherwise confined, positive surgical margins are associated with an excellent prognosis unlikely to be improved by adjuvant therapy.
Ohori
M
M
Matsunaga-Conte Prostate Cancer Research Center, Scott Department of Urology, Baylor College of Medicine, Houston, Texas, USA.
Wheeler
T M
TM
Kattan
M W
MW
Goto
Y
Y
Scardino
P T
PT
D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D005834:Genital Neoplasms, Male / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery; D012669:Seminal Vesicles / Q000473:pathology