Positive Association between Preoperative Total Testosterone Levels and Risk of Positive Surgical Margins by Prostate Cancer: Results in 476 Consecutive Patients Treated Only by Radical Prostatectomy

2018 ◽  
Vol 101 (1) ◽  
pp. 38-46 ◽  
Author(s):  
Antonio Benito Porcaro ◽  
Alessandro Tafuri ◽  
Marco Sebben ◽  
Paolo Corsi ◽  
Tania Pocessali ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Positive Association ◽  
Surgical Margins ◽  
Total Testosterone ◽  
Positive Surgical Margins ◽  
Testosterone Levels

scholarly journals Oncological outcome of neoadjuvant low-dose estramustine plus LHRH agonist/antagonist followed by extended radical prostatectomy for Japanese patients with high-risk localized prostate cancer: a prospective single-arm study

2019 ◽  
Vol 50 (1) ◽  
pp. 66-72 ◽  
Author(s):  
Hideki Enokida ◽  
Yasutoshi Yamada ◽  
Shuichi Tatarano ◽  
Hirofumi Yoshino ◽  
Masaya Yonemori ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Radical Prostatectomy ◽  
Cox Regression ◽  
External Beam Radiotherapy ◽  
Oncological Outcome ◽  
Muscle Layer ◽  
Surgical Margins ◽  
Positive Surgical Margins ◽  
Cox Regression Analysis

Abstract Background Patients with advanced high-risk prostate cancer (PCa) are prone to have worse pathological diagnoses of positive surgical margins and/or lymph node invasion, resulting in early biochemical recurrence (BCR) despite having undergone radical prostatectomy (RP). Therefore, it is controversial whether patients with high-risk PCa should undergo RP. The purpose of this study was to evaluate the efficacy of neoadjuvant chemohormonal therapy (NAC) followed by “extended” RP. Methods A total of 87 patients with high-risk PCa prospectively underwent extended RP after NAC; most of the patients underwent 6 months of estramustine phosphate (EMP) 140 mg twice daily, along with a luteinizing hormone-releasing hormone agonist/antagonist. We developed our surgical technique to reduce the rate of positive surgical margins. We aimed to approach the muscle layer of the rectum by dissecting the mesorectal fascia and continuing the dissection through the mesorectum until the muscle layer of the rectum was exposed. Results More than 1 year had elapsed after surgery in all 86 patients, with a median follow-up period of 37.7 months. The 3-year BCR-free survival was 74.9%. Multivariate Cox-regression analysis revealed that a positive core ratio of 50% or greater and pathological stage of pT3 or greater were independent predictors for BCR. About 17 of 23 cases received salvage androgen deprivation therapy and concurrent external beam radiotherapy, and showed no progression after the salvage therapies. Conclusions NAC concordant with extended RP is feasible and might provide good cancer control for patients with high-risk PCa.

PSA levels and the rate of positive surgical margins in radical prostatectomy specimens preceded by androgen blockade in clinical B2 (T2bNxMo) prostate cancer

Urology ◽  
1997 ◽  
Vol 49 (3) ◽  
pp. 70-73 ◽  
Author(s):  
David G. McLeod ◽  
Charles F. Johnson ◽  
Eric Klein ◽  
James O. Peabody ◽  
Scott Coffield ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Surgical Margins ◽  
Positive Surgical Margins ◽  
Androgen Blockade

Defining predictors of early, intermediate, and late biochemical recurrence in men with clinically localized prostate cancer treated with minimally invasive radical prostatectomy.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 113-113
Author(s):  
Silvia Garcia Barreras ◽  
Igor Nunes-Silva ◽  
Rafael Sanchez-Salas ◽  
Fernando P. Secin ◽  
Victor Srougi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Logistic Regression ◽  
Lymph Node ◽  
Laparoscopic Surgery ◽  
Radical Prostatectomy ◽  
Minimally Invasive ◽  
Biochemical Recurrence ◽  
Surgical Margins ◽  
Positive Surgical Margins

113 Background: Follow up after radical prostatectomy should be tailored to clinical and pathologic characteristics. To determine predictive factors for early, intermediate and late biochemical recurrence (BCR) after minimally invasive radical prostatectomy (MIRP: lap and robot) in patients with localized prostate cancer (PCa). Methods: Prospective clinical, pathologic, and outcome data were collected for 6195 patients with cT1-3N0M0 PCa treated with MIRP at our institution from 2000 to 2016. None of them received neoadjuvant therapy. BCR was defined as PSA level greater than 0.2 ng/ml. Time to BCR was divided in terciles to identify variables associated with early ( < 12 months), intermediate (12-36 months) and late BCR ( > 36 months). Comparisons among groups were performed using ANOVA or Chi square test. Logistic regression models were built to determine risk factors associated with BCR at each time interval. Results: We identified 1148 (19%) patients with BCR. Median time to BCR was 24 months. Statistically significant differences were found between the groups concerning PSA preoperative, D’Amico risk, type of surgery, pT stage, pathological Gleason, positive margins and extracapsular extension. Multivariable logistic regression analysis showed preoperative PSA, positive nodes, positive surgical margins and laparoscopic surgery were associated with early BCR. Laparoscopic surgery was the only risk factor associated with intermediate term BCR. Significant predictors of late BCR included Gleason ≥ 7, ≥ pT3, positive surgical margins, lymph node dissection performance and laparoscopic surgery. Conclusions: Patients with high risk features like Gleason ≥ 7, ≥ pT3 and or positive surgical margins may develop late recurrence and deserve long term follow up. Identify patients with higher PSA and lymph node invasion has an important predictive role due to the risk of BCR within the first year. The association between laparoscopic technique and late BCR deserves further evaluation.

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