Clinical outcomes for men with positive surgical margins after radical prostatectomy—results from the South Australian Prostate Cancer Clinical Outcomes Collaborative community-based registry

作     者：Kerri R.Beckmann Michael E.O'Callaghan Andrew D.Vincent Kim L.Moretti Nicholas R.Brook Kerri R.Beckmann;Michael E.O'Callaghan;Andrew D.Vincent;Kim L.Moretti;Nicholas R.Brook

作者机构：Cancer Epidemiology and Population Health ResearchUniversity of South AustraliaAdelaideAustralia Translational Oncology and Urology ResearchDivision of Pharmaceutical and Cancer StudiesKings College LondonLondonUK South Australian Prostate Cancer Clinical Outcomes CollaborativeFlinders Medical CentreAdelaideAustralia The Freemason's Foundation Centre for Men's HealthAdelaide Medical SchoolUniversity of AdelaideAdelaideAustralia Discipline of SurgeryUniversity of AdelaideAdelaideAustralia Department of UrologyRoyal Adelaide HospitalAdelaideAustralia 

出 版 物：《Asian Journal of Urology》 (亚洲泌尿外科杂志（英文）)

年 卷 期：2023年第10卷第4期

页      面：502-511页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：Dr.Kerri R.Beckmann was supported by the NHMRC Early Career Researcher Fellowship(Gnt#1124210).The South Australian Prostate Cancer Clinical Outcomes Collaborative receives funding to support the Registry from the following:Movember Foundation,Urological Society of Australia and New Zealand(SA-NT Section),the Hospital Research Foundation,Mundi Pharma and Genesis Care.This funding supported the collection of data in the registry,but not this specific project.The funders had no role in the design or conduct of the study the collection,management,analysis,and interpretation of data writing of the manuscript or decision to submit for publication 

主　　题：Prostate cancer Positive surgical margin Biochemical recurrence Radical 

摘      要：Objective Positive surgical margins(PSMs)after radical prostatectomy(RP)indicate failure of surgery to completely clear *** confer an increased risk of biochemical recurrence(BCR),but how more robust outcomes are affected is *** study investigated factors associated with PSMs following RP and determined their impact on clinical outcomes(BCR,second treatment[radiotherapy and/or androgen deprivation therapy],and prostate cancer-specific mortality[PCSM]).Methods The study cohort included men diagnosed with prostate cancer(pT2-3b/N0/M0)between January 1998 and June 2016 who underwent RP from the South Australian Prostate Cancer Clinical Outcomes Collaborative *** associated with risk of PSMs were identified using Poisson *** impact of PSMs on clinical outcomes(BCR,second treatment,and PCSM)was assessed using competing risk *** Of the 2827 eligible participants,28%had PSMs—10%apical,6%bladder neck,17%posterolateral,and 5%at multiple *** follow-up was 9.6 years with 81 deaths from prostate cancer *** of PSM increased with higher pathological grade and pathological tumor stage,and greater tumour volume,but decreased with increasing surgeon volume(odds ratio[OR]:0.93;95%confidence interval[CI]:0.88-0.98,per 100 previous prostatectomies).PSMs were associated with increased risk of BCR(adjusted sub-distribution hazard ratio[sHR]2.5;95%CI 2.1-3.1)and second treatment(sHR 2.9;95%CI 2.4-3.5).Risk of BCR was increased similarly for each PSM location,but was higher for multiple margin *** found no association between PSMs and *** Our findings support previous research suggesting that PSMs are not independently associated with PCSM despite strong association with *** PSM rates remains an important objective,given the higher likelihood of secondary treatment with associated comorbidities.