Prostate Cancer

Review Article

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

Table 7

Modification of PSA failure rates according to PSM length or number of PSM, at 10 years (unless specified).
First author, yr Cohort yearsPSA fail criterion ng/mLMedian f/u, yrPSM, overall%Biochemical failure rateAccording to length at marginAccording to number of PSM
PSMNSM value,
HR		Fail rate with PSMHR and valueFail rate with PSMHR and value
Brimo
2010 [36]		108†1995–2008≥0.23.0Inclusion criterion——>3 mm:
as continuous variable
——
van Oort
2010 [47]		174*1995–2005≥0.13.0Inclusion criterion29—>10 mm,
39% versus 21%		HR 2.3, >1 versus 1HR 1.46
Lake
2010 [48]		19971996–2008>0.24.118, 6.7 for T2ext. 62, focal 3616% extensive 62%,
focal 36%
negative 16%		 ——
Stephenson
2009 [46]		71601995–2006≥0.23.22140 , extensive 66%, focal 34%HR 1.3, †multiple 83%,
one 17%		HR 1.4, MVA †
Shikanov
2009 [49]		13982003–2008≥0.11.017**— , HR 4.4<1 mm 1–3 mm >3 mmHR 0.26
HR 9.6,

HR 14.8,
?
for fail
Goetzl
2009 [50]		1031998–2008≥0.2—23.3——≥6 mmHR 1.7, ≥3 PSM versus 1 versus 2 PSMHR 1.3,
Not sig.
Pfitzenmaier
2008 [29]		4061990–2006≥0.25.217.264.320.5 ,
HR 3.21		——≥3 versus 1
Marks
2007 [51]		1581990–1998≥0.14—55—≥5 mmHR 1.00, ——
Vis
2006 [52]		2811994–1999≥0.16.7523.533.37.9 Focal versus extensive ——
Emerson
2005 [53]		3691999–2003≥0.11.02325.6—Median 3 mm univariate but
.076 multivar.††		Mean 2.45 versus 1.80
by univar. analysis
Sofer
2002 [54]		498≥0.24 yr 5 mo19.7HR 2.8, ≥2, versus 1
Kausik
2002 [31]		1202†††1987–1995>0.24.9423524 —≥2,
62% versus 1, 65%
Fromont
2004 [55]		7341992–1999≥0.225——>2 versus 1HR 2.19,
not done
*Study used 5-year biochemical recurrence.
**Robotic only.
†But a predictive model nomogram does not improve accuracy of predicting failure after prostatectomy.
††Linear extent of positivity was associated with other pathologic variables such as preoperative PSA and tumor volume and not independently predictive when adjusted for Gleason score.
†††pT3 cases only.