Ohori M, Wheeler T M, Kattan M W, Goto Y, Scardino P T
Matsunaga-Conte Prostate Cancer Research Center, Scott Department of Urology, Baylor College of Medicine, Houston, Texas, USA.
J Urol. 1995 Nov;154(5):1818-24.
The prognostic significance of positive surgical margins in radical prostatectomy specimens was assessed.
The interval to progression (increasing prostate specific antigen level) was measured in 478 patients by status of the surgical margins.
At 5 years, the nonprogression rate was 64% for patients with and 83% for those without positive surgical margins. With a high grade cancer, seminal vesicle invasion or lymph node metastases, positive surgical margins had no effect on prognosis; with extracapsular extension and a Gleason score of 6 or less positive surgical margins were associated with a higher progression rate.
Prognosis was adversely affected by positive surgical margins only in moderately differentiated cancers with extracapsular extension alone. If the cancer is otherwise confined, positive surgical margins are associated with an excellent prognosis unlikely to be improved by adjuvant therapy.
评估根治性前列腺切除标本中手术切缘阳性的预后意义。
根据手术切缘状态，对478例患者的疾病进展间隔时间（前列腺特异性抗原水平升高）进行了测量。
5年后，手术切缘阳性患者的无进展率为64%，手术切缘阴性患者为83%。对于高级别癌症、精囊侵犯或淋巴结转移患者，手术切缘阳性对预后无影响；对于包膜外侵犯且Gleason评分6分及以下患者，手术切缘阳性与更高的进展率相关。
仅在单纯包膜外侵犯的中度分化癌中，手术切缘阳性会对预后产生不利影响。如果癌症在其他方面受到局限，手术切缘阳性与良好的预后相关，辅助治疗不太可能改善这种预后。
