Predictive Value of Positive Surgical Margins after Radical Prostatectomy for Lymph Node Metastasis in Locally Advanced Prostate Carcinoma. (3rd October 2011)

• Record Type: Journal Article
• Authors: Otto, Wolfgang; Gerber, Peter; Rößler, Wolfgang; Wieland, Wolf F.; Denzinger, Stefan
• Other Names: Burger Maximilian Academic Editor.
• Is Part Of: Advances in urology. Volume 2012(2012)
• Publication Date: 2011-10-03
• Subjects: Urology -- Periodicals; 616.6005
• DOI: 10.1155/2012/618574
• Languages: English
• ISSNs: 1687-6369

Abstract

Abstract : Introduction . Suspected locally advanced prostate carcinoma shows lymph node involvement in a high percentage of cases. For a long time, such patients were not radically prostatectomised. In recent years, however, this viewpoint has changed. Material and Methods . We analysed a single-centre series of 34 patients with suspected locally advanced prostate cancer to establish predictive parameters for lymph node metastasis. All patients underwent radical prostatectomy between 2007 and 2010. Results . Of the 34 patients, 26% showed pathological stage T3a, 59% pT3b, and 15% pT4. Median preoperative PSA level was 25 ng/mL, and five patients had had neoadjuvant antihormonal treatment. Positive margins were found in 76% of patients. Patients without neoadjuvant treatment showed it in 79%, and after preoperative antihormonal treatment the rate was 60%. Positive margins were associated with lymph node involvement in 85% of cases, complete resection was associated only in 50% of cases. Conclusions . Positive surgical margins play an important predictive role when estimating lymph node involvement in patients with locally advanced prostate carcinoma. Neoadjuvant antihormonal therapy is associated with a relevant reduction in the rate of positive margins but not with the rate of lymph node metastasis. As such, a combination of antihormonal and surgical treatment should be considered.