Positive margins. Surgical techniques and progression after radical prostatectomy

• Published in: Actas urologicas españolas Vol. 21; no. 9; p. 898
• Main Authors: Gil Sanz, M J, Elena, P, Borque Fernando, A, Bono Ariño, A, García Julián, G, Rioja Sanz, L A
• Format: Journal Article
• Language: Spanish
• Published: Spain 01-10-1997
• Subjects: Adenocarcinoma - pathology; Adenocarcinoma - surgery; Disease Progression; Humans; Male; Middle Aged; Neoplasm Staging; Neoplasm, Residual; Prostatectomy - methods; Prostatic Neoplasms - pathology; Prostatic Neoplasms - surgery
• ISSN: 0210-4806

Repercussion of positive surgical borders (SB+) after radical prostatectomy (RP) in the oncological management of this condition is not yet well defined. The article analyzes their incidence and relevance for tumoral progression.
A review of 204 RPs is made. The erectors' preservation technique has been preferentially used until 1994, while the extracapsular standard technique was used afterwards. SB+ have been correlated to pre-operative PSA, Gleason grade, pathological stage and surgical technique. Also, status of borders has been correlated to progression.
SB+ have been detected in 88 patients (43.13%) and were significantly correlated to the pathological stage and Gleason, but not to pre-operative PSA. Although no relation has been ascribed to the surgical technique used in terms of incidence, a decrease of posterolateral borders from 51.8% to 26.2% has been noticed using the extracapular standard technique. Progression is greater in SB+ patients (27.2% vs. 19.2%) but the difference is not statistically significant. SB+ patients who have progressed had all extracapsular tumour, 66% poorly differentiated.
There is a decrease of posterolateral SB+ when the extracapsular standard technique is used. A correlation between presence of SB+ and progression has not been established. No patients with intracapsular tumour and SB+ has progressed. Therefore, it can be inferred his factor has little influence on the evolution of these patients.