کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4000031 1259365 2013 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Risk factors for biochemical recurrence following radical perineal prostatectomy in a large contemporary series: A detailed assessment of margin extent and location
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی تومور شناسی
پیش نمایش صفحه اول مقاله
Risk factors for biochemical recurrence following radical perineal prostatectomy in a large contemporary series: A detailed assessment of margin extent and location
چکیده انگلیسی

ObjectivesThe implications of positive surgical margin (PSM) extent and location during radical perineal prostatectomy (RPP) have not been assessed in a contemporary series. We aimed to examine the incidence, location, and extent of PSM as well as their impact on biochemical recurrence (BCR) following RPP.Materials and methodsA total of 794 patients underwent RPP by a single surgeon between June 1993 and August 2010. Covariates included age, pathologic T stage, pathologic Gleason sum, preoperative PSA, prostate volume, PSM extent, and location. Life table, Kaplan-Meier, and Cox regression analyses assessed predictors of BCR following RPP.ResultsPSM were recorded in 162 patients (20.4%); of these, 83 (51.2%) were focal (≤1 mm) whereas 79 (48.8%) were broad (>1 mm). Location of PSM was anterior 10.5%, posterior or lateral 14.8%, bladder neck 23.5%, apical 32.1%, and multifocal 19.1%. At a median follow-up of 54 months, the 5-year BCR-free probability was 90.8% in patients with negative margins, 77.5% in patients with focal PSM, and 47.5% in patients with broad PSM. On multivariable analyses adjusted for age, pathologic T stage, pathologic Gleason sum, preoperative PSA, and prostate volume, broad PSM, (HR = 3.49, P < 0.001) as well as anterior (HR = 3.77, P = 0.003), bladder neck (HR = 2.25, P = 0.01) and multifocal (HR = 3.55, P < 0.001) PSM were independent predictors of BCR.ConclusionsIn this study, we present oncologic outcomes following RPP in a large contemporary cohort of patients undergoing RPP. In adjusted analyses, broad and anterior PSM carried the highest risk of recurrence after RPP.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Urologic Oncology: Seminars and Original Investigations - Volume 31, Issue 8, November 2013, Pages 1470–1476
نویسندگان
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