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

Table 8

Location of PSM and their modification of PSA failure rates, at 10 years (unless specified).

First author, yr	𝑛	Cohort years	PSA fail criterion, ng/mL	Medi-an f/u, yr	%PSM, overall	%Biochemical failure rate			Failure according to PSM location		Most common location
						PSM	NSM	𝑃 value, HR	% fail:	HR and 𝑃 value
van Oort; 2010 [47]	174***	1995–2005	≥0.1	3.0	Inclusion criterion	29			—		Post 43%,; ant 35%,; apex 33%
Lake; 2010 [48]	1997	1996–2008	>0.2	4.1	18, 6.7 for T2	Ext. 62 focal 36	16	𝑃<.0001	Apex; Ant; Posterolat	HR 2.24, 𝑃=.03, HR 3.7, 𝑃<.0001 HR 2.5, 𝑃=.002	—
Godoy; 2009 [56]	246^**, ***	2000–2006	>0.15	2.8	Apical surgical, 3.2, apical soft tissue, 6.6; total 9.8	—			Apical surgical 48.6%, apical soft tissue, 4.7%***
Stephenson; 2009 [46]	7160	1995–2006	≥0.2	3.2	21	40	HR=2.3	𝑃<.001	Apex versus other	HR 1.1, 𝑃=.3	—
Shikanov; 2009 [49]	1398	2003–2008	≥0.1	1.0	17**	—	—	𝑃<.0001 HR 4.4	Posterolateral	𝑃=.7 for fail	Posterolat 45%; apex 29%; base 6%
Pfitzenmaier; 2008 [29]	406	1990–2006	≥0.2	5.2	17.2	64.3	20.5	𝑃<.001 HR 3.21	Apex versus nonapex	𝑃=.21
Eastham; 2007 [24]	2442	1983–2004	≥0.2	2.9	11.2,; pT2 7,; pT3 22	25	10	𝑃=.0005 HR 1.39	Posterolat.; Posterior	HR 2.80 HR 1.96 versus neg, 𝑃<.0005	Apex 37%,; posterolat 35%
Chuang; 2007 [41]	135^†***	1993–2004	≥0.2	—	—	28.7***	3.3	𝑃<.0001			posterolat 61.5%; post 19%; ant 9%
Vis; 2006 [52]	281	1994–1999	≥0.1	6.75	23.5	33.3	7.9	𝑃<.005	Apex versus other	𝑃=.65	—
Emerson; 2005 [53]	369	1999–2003	≥0.1	1.0	23	25.6	—		Location, gen’l:Ass’n for # of lateral sites:	𝑃=.437; 𝑃=.06
Pettus; 2004 [57]	498		≥0.2	4.4	19.7			HR 2.9, 𝑃<.05, See breakdown	apex 21% nonapex 26%	𝑃=.25, HR 2.25, 𝑃<.05, HR 2.96	apex 5.6, nonapex 11.4
Kausik; 2002 [31]	1202^††	1987–1995	>0.2	4.9	42	35	24	𝑃=.0001	—		apex 46% post. 64%
Sofer; 2002 [54]	734	1992–1999	≥0.2		25	—	—	—	—		apex 45%; post. 32%

**Robotic only.
***Study used 5-year biochemical recurrence.
^†pT2 cases only.
^††pT3 cases only.