Frequency of Positive Surgical Margin at Prostatectomy and Its Effect on Patient Outcome

Table 5

Modification of PSA failure rates according to grade, at 10 years (unless specified).

First author, yr	𝑛	Cohort years	PSA Fail criterion, ng/mL	% PSM, overall	% biochemical failure rate			Gleason score effect on failure if PSM
					PSM	NSM	𝑃 value, HR	Comparisons	𝑃 value, HR
Ploussard; 2010 [34]	1943	2000–2008	>0.2	25.6	54.2	29.9	𝑃<.001; HR 2.6	≤7 versus ≥8	𝑃<.001; 𝑃=.115
Budäus; 2010 [35]	4490	1992–2008	≥0.1	18.9	—	—		compared to GS=6: for 3 + 4, for 4 + 3, for ≥8,	HR 2.81; HR 6.57 HR 9.86,; all 𝑃<.001
Brimo; 2010 [36]	108^†	1995–2008	≥0.2	Inclusion criterion^†	—	—		Score at margin	𝑃=.007
Alkhateeb; 2010 [44]	11,729^‡	1992–2008	≥0.4	31.1	56	77	𝑃<.0001; HR 1.63	Low risk 5.1% versus 0.4%; med. risk 17% versus 65%; hi. risk 43.9% versus 21.5%	—
Orvieto; 2006 [4]	996	1994–2004	≥0.1	All 8.8; pT2 1.7, pT3a 24.9, pT3b 27.1	35	7.8	𝑃<.001; HR 3.27	7 versus ≥8,	𝑃<.001, HR 7.2; 𝑃<.001, HR 21
Karakiewicz; 2005 [42]	5831	1983–2000	≥0.1 to ≥0.4	26.7	63.9	29.9	𝑃=.001; HR 3.66	≥7	𝑃≤.008, HR 2.81

^†Restricted to GS=7, stage pT3a, and PSM.
^‡Risk groups based on Gleason score and preoperative PSA: low = PSA <10, Gleason ≤6; medium = PSA 10–20 or Gleason 7; high = PSA >20 or Gleason ≥8.