Positive surgical margins after radical prostatectomy: A systematic review and contemporary update

European Urology

Volumn 65, Issue 2, 2014, Pages 303-313

  Yossepowitch, Ofer ^a   Briganti, Alberto ^b   Eastham, James A ^c   Epstein, Jonathan ^d   Graefen, Markus ^e   Montironi, Rodolfo ^f   Touijer, Karim ^c  

^a RABIN MEDICAL CENTER   (Israel)

^b VITA SALUTE SAN RAFFAELE UNIVERSITY   (Italy)

^c MEMORIAL SLOAN KETTERING CANCER CENTER   (United States)

^d JOHNS HOPKINS HOSPITAL   (United States)

^e UNIVERSITY OF HAMBURG   (Germany)

^f UNIVERSITÀ POLITECNICA DELLE MARCHE   (Italy)

Author keywords

Frozen section analysis; Metastasis; Nerve sparing; Positive surgical margins; Prostate cancer; Radiation therapy; Robot assisted laparoscopic radical prostatectomy; Survival

Indexed keywords

PROSTATE SPECIFIC ANTIGEN;

CANCER ADJUVANT THERAPY; CANCER INCIDENCE; CANCER RADIOTHERAPY; CLINICAL ASSESSMENT; EVIDENCE BASED PRACTICE; FROZEN SECTION; HUMAN; LAPAROSCOPIC SURGERY; MALE; PATHOLOGIST; POSITIVE SURGICAL MARGIN; PRIORITY JOURNAL; PROSTATECTOMY; REVIEW; ROBOTICS; SURGICAL APPROACH; SYSTEMATIC REVIEW; WORK EXPERIENCE;

FROZEN-SECTION ANALYSIS; METASTASIS; NERVE SPARING; POSITIVE SURGICAL MARGINS; PROSTATE CANCER; RADIATION THERAPY; ROBOT-ASSISTED LAPAROSCOPIC RADICAL PROSTATECTOMY; SURVIVAL;

DISEASE PROGRESSION; FROZEN SECTIONS; HUMANS; LAPAROSCOPY; MALE; NEOPLASM RECURRENCE, LOCAL; NEOPLASM, RESIDUAL; PREDICTIVE VALUE OF TESTS; PROSTATECTOMY; PROSTATIC NEOPLASMS; RADIOTHERAPY, ADJUVANT; RISK FACTORS; SALVAGE THERAPY; TIME FACTORS; TREATMENT OUTCOME;

EID: 84891833099     PISSN: 03022838     EISSN: 18737560     Source Type: Journal    
DOI: 10.1016/j.eururo.2013.07.039     Document Type: Review

References (74)

1. O. Yossepowitch, A. Bjartell, and J.A. Eastham et al. Positive surgical margins in radical prostatectomy: outlining the problem and its long-term consequences Eur Urol 55 2009 87 99
2. W.T. Lowrance, J.A. Eastham, and C. Savage et al. Contemporary open and robotic radical prostatectomy practice patterns among urologists in the United States J Urol 187 2012 2087 2092
3. P.H. Tan, L. Cheng, and J.R. Srigley et al. International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 5: surgical margins Mod Pathol 24 2011 48 57
4. G.W. Bong, C.W. Ritenour, A.O. Osunkoya, M.T. Smith, and T.E. Keane Evaluation of modern pathological criteria for positive margins in radical prostatectomy specimens and their use for predicting biochemical recurrence BJU Int 103 2009 327 331
5. R.E. Emerson, M.O. Koch, J.K. Daggy, and L. Cheng Closest distance between tumor and resection margin in radical prostatectomy specimens: lack of prognostic significance Am J Surg Pathol 29 2005 225 229
6. J.I. Epstein, and J. Sauvageot Do close but negative margins in radical prostatectomy specimens increase the risk of postoperative progression? J Urol 157 1997 241 243
7. J. Lu, G.J. Wirth, and S. Wu et al. A close surgical margin after radical prostatectomy is an independent predictor of recurrence J Urol 188 2012 91 97
8. S. Shikanov, P. Marchetti, and V. Desai et al. Short (≤1 mm) positive surgical margin and risk of biochemical recurrence after radical prostatectomy BJU Int 111 2013 559 563
9. O. Yossepowitch, K. Sircar, and P.T. Scardino et al. Bladder neck involvement in pathological stage pT4 radical prostatectomy specimens is not an independent prognostic factor J Urol 168 2002 2011 2015
10. O. Yossepowitch, D. Engelstein, M. Konichezky, A. Sella, P.M. Livne, and J. Baniel Bladder neck involvement at radical prostatectomy: positive margins or advanced T4 disease? Urology 56 2000 448 452
11. P.A. Fontenot, and A.M. Mansour Reporting positive surgical margins after radical prostatectomy: time for standardization BJU Int 111 2013 E290 E299
12. F. Brimo, A.W. Partin, and J.I. Epstein Tumor grade at margins of resection in radical prostatectomy specimens is an independent predictor of prognosis Urology 76 2010 1206 1209
13. D. Cao, A.S. Kibel, F. Gao, Y. Tao, and P.A. Humphrey The Gleason score of tumor at the margin in radical prostatectomy is predictive of biochemical recurrence Am J Surg Pathol 34 2010 994 1001
14. J.G. Huang, J. Pedersen, and M.K. Hong et al. Presence or absence of a positive pathological margin outperforms any other margin-associated variable in predicting clinically relevant biochemical recurrence in Gleason 7 prostate cancer BJU Int 111 2013 921 927
15. A.Y. Chuang, and J.I. Epstein Positive surgical margins in areas of capsular incision in otherwise organ-confined disease at radical prostatectomy: histologic features and pitfalls Am J Surg Pathol 32 2008 1201 1206
16. I.M. van Oort, H.M. Bruins, L.A. Kiemeney, B.C. Knipscheer, J.A. Witjes, and C.A. Hulsbergen-van de Kaa The length of positive surgical margins correlates with biochemical recurrence after radical prostatectomy Histopathology 56 2010 464 471
17. R.E. Emerson, M.O. Koch, T.D. Jones, J.K. Daggy, B.E. Juliar, and L. Cheng The influence of extent of surgical margin positivity on prostate specific antigen recurrence J Clin Pathol 58 2005 1028 1032
18. D.A. Barocas, M. Han, and J.I. Epstein et al. Does capsular incision at radical retropubic prostatectomy affect disease-free survival in otherwise organ-confined prostate cancer? Urology 58 2001 746 751
19. B. Djavan, S. Milani, and Y.K. Fong Benign positive margins after radical prostatectomy means a poor prognosis - pro Urology 65 2005 218 220
20. G. Godoy, B.U. Tareen, and H. Lepor Does benign prostatic tissue contribute to measurable PSA levels after radical prostatectomy? Urology 74 2009 167 170
21. R. Savdie, L.G. Horvath, and R.P. Benito et al. High Gleason grade carcinoma at a positive surgical margin predicts biochemical failure after radical prostatectomy and may guide adjuvant radiotherapy BJU Int 109 2012 1794 1800
22. A. Tewari, P. Sooriakumaran, D.A. Bloch, U. Seshadri-Kreaden, A.E. Hebert, and P. Wiklund Positive surgical margin and perioperative complication rates of primary surgical treatments for prostate cancer: a systematic review and meta-analysis comparing retropubic, laparoscopic, and robotic prostatectomy Eur Urol 62 2012 1 15
23. K. Touijer, J.A. Eastham, and F.P. Secin et al. Comprehensive prospective comparative analysis of outcomes between open and laparoscopic radical prostatectomy conducted in 2003 to 2005 J Urol 179 2008 1811 1817 discussion 1817
24. G. Novara, V. Ficarra, and S. Mocellin et al. Systematic review and meta-analysis of studies reporting oncologic outcome after robot-assisted radical prostatectomy Eur Urol 62 2012 382 404
25. A.L. Wiltz, S. Shikanov, and S.E. Eggener et al. Robotic radical prostatectomy in overweight and obese patients: oncological and validated-functional outcomes Urology 73 2009 316 322
26. B.A. Link, R. Nelson, and D.Y. Josephson et al. The impact of prostate gland weight in robot assisted laparoscopic radical prostatectomy J Urol 180 2008 928 932
27. A.C. Huang, K.J. Kowalczyk, and N.D. Hevelone et al. The impact of prostate size, median lobe, and prior benign prostatic hyperplasia intervention on robot-assisted laparoscopic prostatectomy: technique and outcomes Eur Urol 59 2011 595 603
28. S. Ginzburg, F. Hu, and I. Staff et al. Does prior abdominal surgery influence outcomes or complications of robotic-assisted laparoscopic radical prostatectomy? Urology 76 2010 1125 1129
29. V.R. Patel, R.F. Coelho, and B. Rocco et al. Positive surgical margins after robotic assisted radical prostatectomy: a multi-institutional study J Urol 186 2011 511 516
30. S.A. Boorjian, R.J. Karnes, and P.L. Crispen et al. The impact of positive surgical margins on mortality following radical prostatectomy during the prostate specific antigen era J Urol 183 2010 1003 1009
31. H.J. Chalfin, M. Dinizo, and B.J. Trock et al. Impact of surgical margin status on prostate-cancer-specific mortality BJU Int 110 2012 1684 1689
32. J. Mauermann, V. Fradet, and L. Lacombe et al. The impact of solitary and multiple positive surgical margins on hard clinical end points in 1712 adjuvant treatment-naive pT2-4 N0 radical prostatectomy patients Eur Urol 64 2013 19 25
33. J. Pfitzenmaier, S. Pahernik, T. Tremmel, A. Haferkamp, S. Buse, and M. Hohenfellner Positive surgical margins after radical prostatectomy: do they have an impact on biochemical or clinical progression? BJU Int 102 2008 1413 1418
34. J.L. Wright, B.L. Dalkin, and L.D. True et al. Positive surgical margins at radical prostatectomy predict prostate cancer specific mortality J Urol 183 2010 2213 2218
35. N.M. Corcoran, C.M. Hovens, and C. Metcalfe et al. Positive surgical margins are a risk factor for significant biochemical recurrence only in intermediate-risk disease BJU Int 110 2012 821 827
36. I.M. Thompson, C.M. Tangen, and J. Paradelo et al. Adjuvant radiotherapy for pathological T3N0M0 prostate cancer significantly reduces risk of metastases and improves survival: long-term followup of a randomized clinical trial J Urol 181 2009 956 962
37. T.J. Wilt, M.K. Brawer, and K.M. Jones et al. Radical prostatectomy versus observation for localized prostate cancer New Engl J Med 367 2012 203 213
38. A. Vickers, C. Bennette, and G. Steineck et al. Individualized estimation of the benefit of radical prostatectomy from the Scandinavian Prostate Cancer Group randomized trial Eur Urol 62 2012 204 209
39. Y.M. Hong, J.C. Hu, A.T. Paciorek, S.J. Knight, and P.R. Carroll Impact of radical prostatectomy positive surgical margins on fear of cancer recurrence: results from CaPSURE Urol Oncol 28 2010 268 273
40. A. Vickers, F. Bianco, and A. Cronin et al. The learning curve for surgical margins after open radical prostatectomy: implications for margin status as an oncological end point J Urol 183 2010 1360 1365
41. F.P. Secin, C. Savage, and C. Abbou et al. The learning curve for laparoscopic radical prostatectomy: an international multicenter study J Urol 184 2010 2291 2296
42. P. Sooriakumaran, M. John, P. Wiklund, D. Lee, A. Nilsson, and A.K. Tewari Learning curve for robotic assisted laparoscopic prostatectomy: a multi-institutional study of 3794 patients Ital J Urol Nephrol 63 2011 191 198
43. R. Albadine, M.E. Hyndman, and A. Chaux et al. Characteristics of positive surgical margins in robotic-assisted radical prostatectomy, open retropubic radical prostatectomy, and laparoscopic radical prostatectomy: a comparative histopathologic study from a single academic center Hum Pathol 43 2012 254 260
44. S.B. Williams, A.V. D'Amico, A.C. Weinberg, X. Gu, S.R. Lipsitz, and J.C. Hu Population-based determinants of radical prostatectomy surgical margin positivity BJU Int 107 2011 1734 1740
45. P. Wolanski, C. Chabert, L. Jones, T. Mullavey, S. Walsh, and T. Gianduzzo Preliminary results of robot-assisted laparoscopic radical prostatectomy (RALP) after fellowship training and experience in laparoscopic radical prostatectomy (LRP) BJU Int 110 Suppl 4 2012 64 70
46. A.K. Tewari, N.D. Patel, and R.A. Leung et al. Visual cues as a surrogate for tactile feedback during robotic-assisted laparoscopic prostatectomy: posterolateral margin rates in 1340 consecutive patients BJU Int 106 2010 528 536
47. V.R. Patel, O. Schatloff, and S. Chauhan et al. The role of the prostatic vasculature as a landmark for nerve sparing during robot-assisted radical prostatectomy Eur Urol 61 2012 571 576
48. A.K. Tewari, A. Srivastava, and K. Mudaliar et al. Anatomical retro-apical technique of synchronous (posterior and anterior) urethral transection: a novel approach for ameliorating apical margin positivity during robotic radical prostatectomy BJU Int 106 2010 1364 1373
49. H. Sasaki, J. Miki, and T. Kimura et al. Lateral view dissection of the prostato-urethral junction to reduce positive apical margin in laparoscopic radical prostatectomy Int J Urol 16 2009 664 669
50. K.A. Guru, A.E. Perlmutter, and M.J. Sheldon et al. Apical margins after robot-assisted radical prostatectomy: does technique matter? J Endourol 23 2009 123 127
51. H. Sasaki, J. Miki, and T. Kimura et al. Upfront transection and subsequent ligation of the dorsal vein complex during laparoscopic radical prostatectomy Int J Urol 17 2010 960 961
52. M.A. Preston, M. Carrière, and G. Raju et al. The prognostic significance of capsular incision into tumor during radical prostatectomy Eur Urol 59 2011 613 618
53. F.P. Secin, A. Serio, and F.J. Bianco Jr. et al. Preoperative and intraoperative risk factors for side-specific positive surgical margins in laparoscopic radical prostatectomy for prostate cancer Eur Urol 51 2007 764 771
54. C. Eichelberg, A. Erbersdobler, and A. Haese et al. Frozen section for the management of intraoperatively detected palpable tumor lesions during nerve-sparing scheduled radical prostatectomy Eur Urol 49 2006 1011 1018 discussion 1016-8
55. T. Tsuboi, M. Ohori, and K. Kuroiwa et al. Is intraoperative frozen section analysis an efficient way to reduce positive surgical margins? Urology 66 2005 1287 1291
56. H. Lepor, and L. Kaci Role of intraoperative biopsies during radical retropubic prostatectomy Urology 63 2004 499 502
57. Y. Kakiuchi, B. Choy, and J. Gordetsky et al. Role of frozen section analysis of surgical margins during robot-assisted laparoscopic radical prostatectomy: a 2608-case experience Hum Pathol 44 2013 1556 1562
58. H. Ye, X. Kong, and T.W. He et al. Intraoperative frozen section analysis of urethral margin biopsies during radical prostatectomy Urology 78 2011 399 404
59. T. Schlomm, P. Tennstedt, and C. Huxhold et al. Neurovascular structure-adjacent frozen-section examination (NeuroSAFE) increases nerve-sparing frequency and reduces positive surgical margins in open and robot-assisted laparoscopic radical prostatectomy: experience after 11 069 consecutive patients Eur Urol 62 2012 333 340
60. C. von Bodman, M. Brock, and F. Roghmann et al. Intraoperative frozen section of the prostate decreases positive margin rate while ensuring nerve sparing procedure during radical prostatectomy J Urol 190 2013 515 520
61. T. Wiegel, D. Bottke, and U. Steiner et al. Phase III postoperative adjuvant radiotherapy after radical prostatectomy compared with radical prostatectomy alone in pT3 prostate cancer with postoperative undetectable prostate-specific antigen: ARO 96-02/AUO AP 09/95 J Clin Oncol 27 2009 2924 2930
62. M. Bolla, H. van Poppel, and L. Collette et al. Postoperative radiotherapy after radical prostatectomy: a randomised controlled trial (EORTC trial 22911) Lancet 366 2005 572 578
63. I.M. Thompson Jr., C.M. Tangen, and J. Paradelo et al. Adjuvant radiotherapy for pathologically advanced prostate cancer: a randomized clinical trial JAMA 296 2006 2329 2335
64. M. Bolla, H. van Poppel, and B. Tombal et al. Postoperative radiotherapy after radical prostatectomy for high-risk prostate cancer: long-term results of a randomised controlled trial (EORTC trial 22911) Lancet 380 2012 2018 2027
65. T.H. Van der Kwast, M. Bolla, and H. Van Poppel et al. Identification of patients with prostate cancer who benefit from immediate postoperative radiotherapy: EORTC 22911 J Clin Oncol 25 2007 4178 4186
66. M. Spahn, and S. Joniau Positive surgical margin at radical prostatectomy: futile or surgeon-dependent predictor of prostate cancer death? Eur Urol 64 2013 26 28
67. S.E. Eggener, P.T. Scardino, and P.C. Walsh et al. Predicting 15-year prostate cancer specific mortality after radical prostatectomy J Urol 185 2011 869 875
68. Suardi N, Gallina A, Lista G, et al. Impact of adjuvant radiation therapy on urinary continence recovery after radical prostatectomy. Eur Urol. In press. http://dx.doi.org/10.1016/j.eururo.2013.01.027.
69. B.J. Trock, M. Han, and S.J. Freedland et al. Prostate cancer-specific survival following salvage radiotherapy vs observation in men with biochemical recurrence after radical prostatectomy JAMA 299 2008 2760 2769
70. A.J. Stephenson, P.T. Scardino, and M.W. Kattan et al. Predicting the outcome of salvage radiation therapy for recurrent prostate cancer after radical prostatectomy J Clin Oncol 25 2007 2035 2041
71. A. Briganti, T. Wiegel, and S. Joniau et al. Early salvage radiation therapy does not compromise cancer control in patients with pT3N0 prostate cancer after radical prostatectomy: results of a match-controlled multi-institutional analysis Eur Urol 62 2012 472 487
72. E.J. Trabulsi, R.K. Valicenti, and A.L. Hanlon et al. A multi-institutional matched-control analysis of adjuvant and salvage postoperative radiation therapy for pT3-4N0 prostate cancer Urology 72 2008 1298 1302 discussion 1302-4
73. T. Budiharto, C. Perneel, and K. Haustermans et al. A multi-institutional analysis comparing adjuvant and salvage radiation therapy for high-risk prostate cancer patients with undetectable PSA after prostatectomy Radiother Oncol 97 2010 474 479
74. P. Ost, B. De Troyer, V. Fonteyne, W. Oosterlinck, and G. De Meerleer A matched control analysis of adjuvant and salvage high-dose postoperative intensity-modulated radiotherapy for prostate cancer Int J Radiat Oncol Biol Phys 80 2011 1316 1322