title: Risk and timing of biochemical recurrence in pT3aN0/Nx prostate cancer with positive surgical margin - A multicenter study.
abstract: OBJECTIVE
  Positive surgical margins (PSM) after radical prostatectomy have been shown to be associated with impaired outcome. In pT3pN0 patients with PSM either immediate radiotherapy or clinical and biological monitoring followed by salvage radiotherapy is recommended by the latest guidelines of the European Association of Urology.
  
  
  METHODS
  A retrospective, multicenter study of eight urological centers was conducted on 536 prostatectomy patients with pT3aN0/NxR1 tumors and no neoadjuvant/adjuvant therapy. A pathological re-review of all prostate specimens was performed. Association of clinical and pathological features with biochemical recurrence (BCR) was analyzed using univariate and multivariate analysis.
  
  
  RESULTS
  With 48months median follow-up, BCR occurred in 39.7%. Preoperative PSA value, performance of pelvic lymph node dissection and Gleason score were significantly associated with BCR. In multivariate analysis, Gleason score was the only independent prognostic factor (p<0.001) for BCR. Five-year BCR-free survival rates were 74%, 70%, 38%, and 51% with Gleason score 6, 3+4=7a, 4+3=7b, and 8-10, respectively.
  
  
  CONCLUSIONS
  In pT3aN0/NxR1 patients with no adjuvant/neoadjuvant treatment, Gleason Score permits independent prediction of the risk for BCR. These findings could help to estimate and discuss the individual risk for BCR with our patients on an individual basis.
authors.affiliation: Ludwig-Maximilians-University, Dept. of Urology, Munich, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Karl
authors.affiliation: Ludwig-Maximilians-University, Dept. of Urology, Munich, Germany. Electronic address: alexander.buchner@med.uni-muenchen.de.
authors.forename: Alexander
authors.initials: A
authors.lastname: Buchner
authors.affiliation: Ludwig-Maximilians-University, Dept. of Pathology, Munich, Germany.
authors.forename: Christiane
authors.initials: C
authors.lastname: Tympner
authors.affiliation: Ludwig-Maximilians-University, Dept. of Pathology, Munich, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kirchner
authors.affiliation: Ludwig-Maximilians-University, Dept. of Radiation Oncology, Munich, Germany.
authors.forename: Ute
authors.initials: U
authors.lastname: Ganswindt
authors.affiliation: Ludwig-Maximilians-University, Dept. of Radiation Oncology, Munich, Germany.
authors.forename: Claus
authors.initials: C
authors.lastname: Belka
authors.affiliation: University Regensburg, Dept. of Urology, Germany.
authors.forename: Roman
authors.initials: R
authors.lastname: Ganzer
authors.affiliation: University Regensburg, Dept. of Urology, Germany.
authors.forename: Wolf
authors.initials: W
authors.lastname: Wieland
authors.affiliation: University Regensburg, Dept. of Pathology, Germany.
authors.forename: Fabian
authors.initials: F
authors.lastname: Eder
authors.affiliation: University Regensburg, Dept. of Pathology, Germany.
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Hofstädter
authors.affiliation: University Tübingen, Dept. of Urology, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Schilling
authors.affiliation: University Tübingen, Dept. of Urology, Germany.
authors.forename: Karl-Dietrich
authors.initials: KD
authors.lastname: Sievert
authors.affiliation: University Tübingen, Dept. of Urology, Germany.
authors.forename: Arnulf
authors.initials: A
authors.lastname: Stenzl
authors.affiliation: University Tübingen, Dept. of Pathology, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Scharpf
authors.affiliation: University Tübingen, Dept. of Pathology, Germany.
authors.forename: Falko
authors.initials: F
authors.lastname: Fend
authors.affiliation: University Essen, Dept. of Urology, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Vom Dorp
authors.affiliation: University Essen, Dept. of Urology, Germany.
authors.forename: Herbert
authors.initials: H
authors.lastname: Rübben
authors.affiliation: University Essen, Dept. of Pathology, Germany.
authors.forename: Kurt Werner
authors.initials: KW
authors.lastname: Schmid
authors.affiliation: University RWTH Aachen, Dept. of Urology, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Porres-Knoblauch
authors.affiliation: University RWTH Aachen, Dept. of Urology, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Heidenreich
authors.affiliation: University RWTH Aachen, Dept. of Pathology, Germany.
authors.forename: Birgit
authors.initials: B
authors.lastname: Hangarter
authors.affiliation: University RWTH Aachen, Dept. of Pathology, Germany.
authors.forename: Ruth
authors.initials: R
authors.lastname: Knüchel-Clarke
authors.affiliation: University Erlangen, Dept. of Urology, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Rogenhofer
authors.affiliation: University Erlangen, Dept. of Urology, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Wullich
authors.affiliation: University Erlangen, Dept. of Pathology, Germany.
authors.forename: Arndt
authors.initials: A
authors.lastname: Hartmann
authors.affiliation: Zentralkrankenhaus Bozen, Dept. of Urology, Bozen, Italy.
authors.forename: Evi
authors.initials: E
authors.lastname: Comploj
authors.affiliation: Zentralkrankenhaus Bozen, Dept. of Urology, Bozen, Italy.
authors.forename: Armin
authors.initials: A
authors.lastname: Pycha
authors.affiliation: Zentralkrankenhaus Bozen, Dept. of Pathology, Bozen, Italy.
authors.forename: Esther
authors.initials: E
authors.lastname: Hanspeter
authors.affiliation: Martini-Klinik am UKE, Dept. of Urology, Hamburg-Eppendorf, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Pehrke
authors.affiliation: UKE, Dept. of Pathology, Hamburg-Eppendorf, Germany.
authors.forename: Guido
authors.initials: G
authors.lastname: Sauter
authors.affiliation: Martini-Klinik am UKE, Dept. of Urology, Hamburg-Eppendorf, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Graefen
authors.affiliation: Ludwig-Maximilians-University, Dept. of Urology, Munich, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Gratzke
authors.affiliation: Ludwig-Maximilians-University, Dept. of Urology, Munich, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Stief
authors.affiliation: University Ulm, Dept. of Radiation Oncology, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Wiegel
authors.affiliation: Martini-Klinik am UKE, Dept. of Urology, Hamburg-Eppendorf, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Haese
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D012306:Risk; D016879:Salvage Therapy; D015996:Survival Rate
chemical_list: D017430:Prostate-Specific Antigen
keywords: Adjuvant therapy; Localized prostate cancer; Prognostic parameters; Surgical margins