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• W2893099389 abstract "Surgical margin (SM) status after radical prostatectomy (RP) for clinically localized prostate cancer (PCa) is a measure of surgical quality and retains some prognostic value. Positive SMs (PSMs) have long been considered an adverse oncological outcome because they were repeatedly found to be associated with a higher risk of biochemical recurrence (BCR), and are still among the factors guiding the decision to deliver adjuvant treatments; however, the long-term impact of PSMs on survival remains uncertain because it is largely affected by other concurrent risk modifiers 1-3. The clinical significance of so-called close SMs (CSMs), that is, negative SMs (NSMs) with tumour foci approaching, but not involving, the inked cut surface of the RP specimen, is a far less investigated field of research, with contradictory findings in the few available studies (Table 1 4-12). Some studies showed a significant association with risk of disease progression (mainly measured with BCR), while others did not. The study by Herforth et al. 12 published in this issue of BJUI further adds to the debate on CSMs, with an analysis of the largest series reported to date. The authors assessed the impact of CSMs vs NSMs vs PSMs after RP on BCR, PCa-specific and overall survival in ~4 300 men included in the Shared Equal Access Regional Cancer Hospital cohort. CSMs were defined as cancer foci within 1 mm from the inked specimen surface, and were found in 372 patients (9%). The median follow-up was 6.5 years. On multivariable analysis accounting for several established prognostic factors, CSMs were significantly associated with a higher BCR risk compared with NSMs, but a lower risk compared with PSMs. Notably, SM status alone did not influence PCa-specific or overall survival. Major limitations to this retrospective analysis were lack of central pathology review and inadequate follow-up length to assess survival. None declared." @default.
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• W2893099389 date "2018-09-24" @default.
• W2893099389 modified "2023-09-23" @default.
• W2893099389 title "Close surgical margins after radical prostatectomy: how to make a complex story even more complex" @default.
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• W2893099389 doi "https://doi.org/10.1111/bju.14359" @default.
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