470 DO MARGINS MATTER? THE INFLUENCE OF POSITIVE SURGICAL MARGINS ON PROSTATE CANCER-SPECIFIC MORTALITY (2011)

You have accessJournal of UrologyProstate Cancer: Localized1 Apr 2011470 DO MARGINS MATTER? THE INFLUENCE OF POSITIVE SURGICAL MARGINS ON PROSTATE CANCER-SPECIFIC MORTALITY Andrew J. Stephenson, Scott E. Eggener, Eric A. Klein, Adrian V. Hernandez, Michael W. Kattan, David P. Wood, James A. Eastham, and Peter T. Scardino Andrew J. StephensonAndrew J. Stephenson Cleveland, OH More articles by this author , Scott E. EggenerScott E. Eggener Chicago, IL More articles by this author , Eric A. KleinEric A. Klein Cleveland, OH More articles by this author , Adrian V. HernandezAdrian V. Hernandez Cleveland, OH More articles by this author , Michael W. KattanMichael W. Kattan Cleveland, OH More articles by this author , David P. WoodDavid P. Wood Ann Arbor, MI More articles by this author , James A. EasthamJames A. Eastham New York, NY More articles by this author , and Peter T. ScardinoPeter T. Scardino New York, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.564AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Positive surgical margins (PSM) in radical prostatectomy specimens increase the risk of prostate cancer recurrence. However, we previously reported no independent association between PSM and prostate cancer-specific mortality (PCSM). We hypothesized that this lack of association may be due to the protective effect of postoperative radiotherapy on cancer progression. METHODS Fine and Gray competing risk regression analysis was used to model the clinical data and follow-up information of 11,521 patients treated by radical prostatectomy for prostate cancer at 4 academic medical centers between 1987 and 2005. Two extended regression models were also used to analyze the association of PSM with PCSM that adjusted for postoperative radiotherapy, which was handled as a time-dependent covariate. Postoperative radiotherapy was modeled as a single parameter and also as early and late therapy, based on the PSA level at the start of treatment (<= 0.5 vs. > 0.5 ng/mL). RESULTS The 15-year PCSM for patients with PSM and negative SM was 10% and 6%, respectively (P < 0.001). No significant association between PSM and PCSM was observed in the conventional model with fixed covariates (HR 1.04; 95% CI: 0.7–1.5; P = 0.8) or in the two extended models that adjusted for postoperative radiotherapy (HR 0.96; 95% CI: 0.7–1.4; P = 0.9), or early and late postoperative radiotherapy (HR 1.01; 95% CI: 0.7–1.4; P = 0.9). CONCLUSIONS PSM alone are not associated with a significantly increased risk of PCSM within 15 years of radical prostatectomy. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e191 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andrew J. Stephenson Cleveland, OH More articles by this author Scott E. Eggener Chicago, IL More articles by this author Eric A. Klein Cleveland, OH More articles by this author Adrian V. Hernandez Cleveland, OH More articles by this author Michael W. Kattan Cleveland, OH More articles by this author David P. Wood Ann Arbor, MI More articles by this author James A. Eastham New York, NY More articles by this author Peter T. Scardino New York, NY More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...