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Editorial Comment

      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
      • Brimo F.
      • Partin A.W.
      • Epstein J.I.
      Tumor grade at margins of resection in radical prostatectomy specimens is an independent predictor of prognosis.
      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,
      • Quinn D.I.
      • Henshall S.M.
      • Haynes A.M.
      • et al.
      Prognostic significance of pathologic features in localized prostate cancer treated with radical prostatectomy: implications for staging systems and predictive models.
      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.
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      References

        • Brimo F.
        • Partin A.W.
        • Epstein J.I.
        Tumor grade at margins of resection in radical prostatectomy specimens is an independent predictor of prognosis.
        Urology. 2010; (xx:xxx-xxx)
        • Quinn D.I.
        • Henshall S.M.
        • Haynes A.M.
        • et al.
        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
        • Shikanov S.
        • Song J.
        • Royce C.
        • et al.
        Length of positive surgical margin after radical prostatectomy as a predictor of biochemical recurrence.
        J Urol. 2009; 182: 139-144
        • Stephenson A.J.
        • Wood D.P.
        • Kattan M.W.
        • et al.
        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

      Linked Article

      • Tumor Grade at Margins of Resection in Radical Prostatectomy Specimens Is an Independent Predictor of Prognosis
        UrologyVol. 76Issue 5
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          To assess whether reporting the grade of cancer at the site of positive margins in a radical prostatectomy (RP) specimen was independently prognostic of the outcome.
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        UrologyVol. 76Issue 5
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          We 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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