Department of Pathology, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ministry of Health - University of Health Sciences, ANKARA, TURKEY.
Turk Patoloji Derg. 2021;37(3):233-238. doi: 10.5146/tjpath.2021.01546.
To investigate the effect of the distance between tumor and surgical margin on biochemical recurrence in patients with organ-confined prostate cancer.
The data of 208 patients, who underwent radical prostatectomy between 2012-2018, were retrospectively analyzed. The surgical margin status of 147 pathologically organ-confined patients was categorized as positive, close ( < 1mm) and negative. Surgical margin status and parameters affecting biochemical recurrence were examined. Furthermore, multivariate analysis was done to determine the parameters associated with biochemical recurrence.
Biochemical recurrence was detected in 21 (14.2%) of 147 patients. 38 (27.9%) men had negative surgical margins, 68 (46.2%) had close surgical margins and 41 (25.9%) had positive surgical margins. Tumor volume and ISUP grade were found to be statistically significant for positive surgical margin and close surgical margin patients compared to negative surgical margin patients. Close surgical margin was not statistically associated with biochemical recurrence. Preoperative high PSA (p < 0.001) and positive surgical margin (p=0.021) were independent risk factors for biochemical recurrence.
According to our results, it is not necessary to include the presence of a close surgical margin in the pathology reports in patients with pathological organ-confined tumors and negative surgical margins.
研究肿瘤与手术切缘之间的距离对局限性前列腺癌患者生化复发的影响。
回顾性分析了 2012 年至 2018 年间接受根治性前列腺切除术的 208 例患者的数据。对 147 例病理局限性肿瘤患者的手术切缘状态进行了分类,分为阳性、接近(<1mm)和阴性。检查了手术切缘状态和影响生化复发的参数。此外,还进行了多变量分析,以确定与生化复发相关的参数。
在 147 例患者中,有 21 例(14.2%)检测到生化复发。38 例(27.9%)患者的手术切缘为阴性,68 例(46.2%)为接近手术切缘,41 例(25.9%)为阳性手术切缘。与阴性手术切缘患者相比,肿瘤体积和 ISUP 分级对阳性手术切缘和接近手术切缘患者的手术切缘阳性具有统计学意义。接近手术切缘与生化复发无统计学关联。术前高 PSA(p<0.001)和阳性手术切缘(p=0.021)是生化复发的独立危险因素。
根据我们的结果,对于病理局限性肿瘤和阴性手术切缘的患者,在病理报告中不必包括接近手术切缘的存在。