Damani Arees, Van Hemelrijck Mieke, Wulaningsih Wahyu, Crawley Danielle, Cahill Declan
Cancer Epidemiology Group, Division of Cancer Studies, Research Oncology, School of Medicine, Guy's Hospital, King's College London, 3rd Floor, Bermondsey Wing, London, SE1 9RT, UK.
The Royal Marsden NHS Foundation Trust, London, UK.
World J Urol. 2017 Jan;35(1):35-43. doi: 10.1007/s00345-016-1836-0. Epub 2016 Apr 25.
To assess potential biases, such as the reporting pathologist, that may affect objectivity of T2 positive margin rates as a quality outcome measure following radical prostatectomy.
Prospective data on 183 consecutive LRP patients with pT2 disease, operated on by a single surgeon (2003-2009), were studied. Outcomes were grouped as pre-, peri-, and post-operative and included: age, ethnicity, Gleason score, reporting pathologist, percentage of positive cores, operative time, blood loss, nerve-sparing status, hospital stay and prostate weight. Descriptive analysis and logistic regression analysis were carried out to compare these variables by positive margin status.
A total of 30 (16.4 %) positive surgical margins (PSMs) were reported. Surgical stage, earlier date of surgery, and lower prostatic weight showed statistically significant associations with PSM status in both univariate and multivariate analysis. The reporting pathologist was not found to be predictive of PSMs (P = 0.855).
We showed that the reporting pathologist does not influence T2 positive margin status, in contrast to tumour characteristics and surgeon experience. T2 positive margin assessment therefore appears to be an objective quality outcome measure.
评估可能影响前列腺癌根治术后T2切缘阳性率客观性的潜在偏倚因素，如报告病理医师。
对由单一外科医生实施手术（2003 - 2009年）的183例连续的pT2期局限性前列腺癌（LRP）患者的前瞻性数据进行研究。结果分为术前、术中和术后，包括：年龄、种族、Gleason评分、报告病理医师、阳性癌灶百分比、手术时间、失血量、保留神经情况、住院时间和前列腺重量。采用描述性分析和逻辑回归分析按切缘阳性状态比较这些变量。
共报告30例（16.4%）手术切缘阳性（PSM）。在单因素和多因素分析中，手术分期、手术日期较早以及前列腺重量较低与PSM状态均显示出统计学显著相关性。未发现报告病理医师可预测PSM（P = 0.855）。
与肿瘤特征和外科医生经验不同，我们发现报告病理医师不会影响T2切缘阳性状态。因此，T2切缘阳性评估似乎是一种客观的质量结果指标。
