Positive surgical margins and their relevance in predicting biochemical recurrence
(BCR) is currently a “hot” topic in urology studies. Recent publications have suggested
that more detailed annotation of the pathologic parameters related to a positive margin
might provide additional prognostic information. Brimo et al
1
are the first to highlight an association between the Gleason score at a positive
surgical margin and BCR in 108 patients with an overall Gleason score of 7, extraprostatic
extension (EPE), and margin positivity. Given the strong predictive value of the Gleason
score, independent of stage,
2
it is, as the authors suggest, rather intuitive that a more biologically aggressive
tumor component present at a surgical margin would lead to greater BCR rates than
a lower grade component. These investigators argue that, from their results, the Gleason
score of the tumor at a positive surgical margin should be routinely incorporated
into the pathology reports.To read this article in full you will need to make a payment
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References
- Tumor grade at margins of resection in radical prostatectomy specimens is an independent predictor of prognosis.Urology. 2010; (xx:xxx-xxx)
- Prognostic significance of pathologic features in localized prostate cancer treated with radical prostatectomy: implications for staging systems and predictive models.J Clin Oncol. 2001; 19: 3692-3705
- Length of positive surgical margin after radical prostatectomy as a predictor of biochemical recurrence.J Urol. 2009; 182: 139-144
- Location, extent and number of positive surgical margins do not improve accuracy of predicting prostate cancer recurrence after radical prostatectomy.J Urol. 2009; 182: 1357-1363
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© 2010 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
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- Tumor Grade at Margins of Resection in Radical Prostatectomy Specimens Is an Independent Predictor of PrognosisUrologyVol. 76Issue 5
- ReplyUrologyVol. 76Issue 5
- PreviewWe appreciate the comments made by Drs. Reuter and Fine about our publication related to the association between the Gleason grade of cancer at the positive surgical margin and the rate of biochemical recurrence (BCR) after radical prostatectomy (RP). The 2 major concerns raised by the authors were (1) whether the study cohort was “sufficient in number and features to assess the value” of the presented results, and (2) whether the different subclassifications of positive surgical margins have any additive prognostic information altogether.
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