An In-Depth Study of Extraprostatic Extension and Margin Status in Radical Prostatectomies
S Chan, F Garcia, M Moussa, J Chin, M Gabril. LHSC/UWO, London, ON, Canada
Background: In radical prostatectomies for prostate cancer (PCa), a positive margin is defined as tumor in contact with the inked resection margin. Extraprostatic extension (EPE) signifies tumor extending outside the normal confines of the prostate. In this study, we aim to determine the prognostic significance of EPE and positive margins in combination and independently, EPE focality and EPE subtypes.
Design: 148 radical prostatectomies (without neoadjuvant therapy) performed by a single surgeon at our institution (1993-2001) were identified as having EPE/capsular invasion or positive margins. All slides were reviewed and pathological features (Gleason score, PCa volume, seminal vesicle & lymphovascular invasion, lymph node metastasis, margin status and EPE including focality (focal=1 slide, non-focal≥2 slides) and subtype (abut/admixed with fat, level of fat, neurovascular bundle involvement, beyond confines, bulging nodule)) were recorded. Clinical data (age, PSA, biochemical failure, metastasis and survival) was also collected. Cases were subdivided into 4 groups: 1.+EPE only 2.+Margin only 3.+EPE&Margin 4.–EPE&Margin (control).
|+EPE only (n=47)||+Margin Only (n=23)||+EPE&Margin (n=38)||Control (n=40)||P Value|
|%Biochemical Failure (3-160 mo)||42||28||58||13||<.001|
|%Survival (1-6 yrs)||91||100||85||100||.027|