[769] Do Benign Glands at the Resection Margin Increase the Risk of Biochemical Failure Post Radical Prostatectomy?

Susanne M Chan, Francisco J Garcia, Madeleine S Moussa, Joseph L Chin, Manal Y Gabril. London Health Sciences Center/University of Western Ontario, ON, Canada; Division of Urology, London Health Sciences Center/ University of Western Ontario, London, ON, Canada

Background: In radical prostatectomies for prostate cancer (PCa), the effect of benign glands at the resection margins on PSA levels is quesionable. In this study, we compare the risk of biochemical failure post radical prostatectomy in patients who have benign glands at the resection margins vs malignant glands vs no glands.
Design: 58 radical prostatectomies (without neoadjuvant therapy, extraprostatic extension, seminal vesicle invasion or lymph node metastasis) performed by a single surgeon at our institution (1993-2001) were included in this study. All slides from the cases were re-reviewed and pathological features (Gleason grade, PCa volume, margin status (malignant glands, benign glands, no glands at the margin)) were assessed. Clinical data (age, PSA, biochemical failure (3 consecutive rises in PSA with a minimum PSA level of ≥ 0.1 ng/mL), metastasis and survival) was also collected.
Results:

Table 1: Multivariate Statistical Analysis of the 3 Groups
 Malignant Glands (n=18)Benign Glands (n=13)No Glands (n=27)P Value
Median Age, years646161.093
Median Preopertive PSA7.76.96.8.767
Gleason Score (%)   .150
<733837 
≥7679263 
Biochemical Failure (%)28815.437
Average follow up time (months)999785 
*There were no cases of death or metastasis in any of the three groups.

Cox proportional hazards model was used to evaluate biochemical failure, using the no glands group as the reference, with the malignant glands group having a HR=1.72 (95% CI, 0.46 – 6.44) and the benign glands group having a HR=0.42 (95% CI, 0.05 – 3.78).
Conclusions: Our study showed that in cases without extraprostatic extension, seminal vesicle invasion or lymph node metastasis, the presence of benign glands at the resection margin does not increase the risk of biochemical failure when compared to cases that have no glands at the margin. The presence of malignant glands, however, does increase the risk of biochemical failure.
Category: Genitourinary (including renal tumors)

Monday, February 28, 2011 1:00 PM

Poster Session II # 123, Monday Afternoon

 

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