title: Risk of biochemical recurrence and positive surgical margins in patients with pT2 prostate cancer undergoing radical prostatectomy.
abstract: OBJECTIVE
  To investigate risk factors associated with positive surgical margins (PSM) and biochemical recurrence (BR) in organ confined tumors (pT2) after radical prostatectomy (RP) for localized prostate cancer (PCa).
  
  
  METHODS
  Between 1995 and 2011, 1,649 patients underwent RP at our institution. The study includes the 1,133 consecutive patients with pT2 tumors at final histopathology. Logistic regression analysis was used for risk of PSM. Risk of BR, defined as the first PSA ≥ 0.2 ng/ml, was analyzed with Kaplan-Meier and Cox regression analysis.
  
  
  RESULTS
  Median follow-up was 3.6 years (range: 0.5-15.5 years). In logistic regression, NS surgery was independently associated with an increased risk of pT2 PSM (OR = 1.68, 95% CI: 1.3-2.0, P = 0.01) relative to non-NS surgery. NS surgery was not independently associated with BR but the interaction of PSM and NS surgery trended (P = 0.08) to increase the risk of BR compared to PSM and non-NS surgery.
  
  
  CONCLUSIONS
  Several factors influence the risk of pT2 PSMs in radical prostatectomy. In our cohort pT2 PSM is associated with NS surgery and trend to increase risk of BR compared to non-NS surgery. The optimal selection of candidates for NS surgery is still not clear.
authors.affiliation: Copenhagen Prostate Cancer Center, University of Copenhagen, Copenhagen, Denmark; Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Martin Andreas
authors.initials: MA
authors.lastname: Røder
authors.forename: Frederik Birkebæk
authors.initials: FB
authors.lastname: Thomsen
authors.forename: Kasper Drimer
authors.initials: KD
authors.lastname: Berg
authors.forename: I B Jarle
authors.initials: IB
authors.lastname: Christensen
authors.forename: Klaus
authors.initials: K
authors.lastname: Brasso
authors.forename: Ben
authors.initials: B
authors.lastname: Vainer
authors.forename: Peter
authors.initials: P
authors.lastname: Iversen
mesh_terms: D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000097:blood*; D059351:Organ Sparing Treatments; D011467:Prostate / Q000294:innervation; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D012307:Risk Factors
chemical_list: D017430:Prostate-Specific Antigen
keywords: biochemical recurrence; nerve-sparing surgery; positive surgical margins; radical prostatectomy