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2. The impact of prior TURP on radical prostatectomy surgical margins: a multicenter analysis.

Author

Gacci M, Simonato A, Lanciotti M, Ennas M, Varca V, Maffezzini M, Imbimbo C, Gontero P, Schiavina R, Carini M, Martorana G, Nicita G, Mirone V, and Carmignani G

Subjects
Adult, Aged, Aged, 80 and over, Biopsy, Humans, Italy, Male, Middle Aged, Neoplasm Grading, Prognosis, Prostate pathology, Prostate surgery, Prostate-Specific Antigen blood, Risk, Treatment Outcome, Urinary Bladder pathology, Prostatectomy methods, Prostatic Neoplasms surgery, Transurethral Resection of Prostate methods
Abstract

Objective: To analyze positive surgical margins (PSM) after radical prostatectomy (RP) in the overall population and in patients previously treated with transurethral resection of the prostate (TURP)., Materials and Methods: 2,408 patients treated with RP for clinically localized prostate cancer (PCa) were consecutively enrolled in 135 departments. We correlated PSM rates and all preoperative, surgical and pathological features. We stratified the site of PSM as unique or multifocal. Moreover, we analyzed differences between 75 patients who had undergone previous TURP and the remaining 2,333 patients., Results: In the entire study population, we identified 702 patients with PSM (29%). Using univariate analysis, we reported a significant correlation between overall PSM and prostate-specific antigen (PSA), stage cT, biopsy Gleason score, number of biopsy cores, number of positive cores, percentage of positive cores and nerve-sparing approach. PSM proved to be strongly dependent on pT in particular in patients with pT2 PCa. When we compared the data from 75 patients previously treated with TURP and those from 2,333 without previous prostatic surgery, a statistically significant difference in margin localization was found. Moreover, we analyzed the 75 patients mentioned above, stratified in incidental PCa diagnosed at TURP or PCa detected with prostate biopsy for PSA rising during the post-TURP follow-up: no statistical differences were found between the 2 groups regarding margin status, even if PSM were more frequent in incidental PCa with no significance deriving from the stratification for PSM location at the apex or base., Conclusion: Men treated with TURP before RP presented an overall incidence of PSM similar to those without previous TURP, but with a higher risk of PSM at the bladder neck and a lower risk of PSM at the prostatic apex., (Copyright © 2013 S. Karger AG, Basel.)

Published
2013
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4. The impact of prior TURP on radical prostatectomy surgical margins: A multicenter analysis and members of the mirror study, LUNA foundation

Author

Gacci, Mauro, Simonato, Alchiede, Lanciotti, Michele, Ennas, Marco, Varca, Virginia, Maffezzini, Massimo, Imbimbo, Ciro, Gontero, Paolo, Schiavina, Riccardo, Carini, Marco, Martorana, Giuseppe, Nicita, Giulio, Mirone, Vincenzo, Carmignani, Giorgio, Gacci, Mauro, Simonato, Alchiede, Lanciotti, Michele, Ennas, Marco, Varca, Virginia, Maffezzini, Massimo, Imbimbo, Ciro, Gontero, Paolo, Schiavina, Riccardo, Carini, Marco, Martorana, Giuseppe, Nicita, Giulio, Mirone, Vincenzo, and Carmignani, Giorgio

Subjects
Adult, Male, Risk, Prognosi, Biopsy, Urology, Urinary Bladder, Positive surgical margin, urologic and male genital diseases, Aged, Aged, 80 and over, Prostatectomy, Prostate cancer, fungi, Prostate, Transurethral Resection of Prostate, Middle Aged, Prostate-Specific Antigen, Radical prostatectomy, Transurethral prostate resection, Positive surgical margins, Humans, Italy, Neoplasm Grading, Prognosis, Prostatic Neoplasms, Treatment Outcome, Prostatic Neoplasm, Human
Abstract

Objective: To analyze positive surgical margins (PSM) after radical prostatectomy (RP) in the overall population and in patients previously treated with transurethral resection of the prostate (TURP). Materials and Methods: 2,408 patients treated with RP for clinically localized prostate cancer (PCa) were consecutively enrolled in 135 departments. We correlated PSM rates and all preoperative, surgical and pathological features. We stratified the site of PSM as unique or multifocal. Moreover, we analyzed differences between 75 patients who had undergone previous TURP and the remaining 2,333 patients. Results: In the entire study population, we identified 702 patients with PSM (29%). Using univariate analysis, we reported a significant correlation between overall PSM and prostate-specific antigen (PSA), stage cT, biopsy Gleason score, number of biopsy cores, number of positive cores, percentage of positive cores and nerve-sparing approach. PSM proved to be strongly dependent on pT in particular in patients with pT2 PCa. When we compared the data from 75 patients previously treated with TURP and those from 2,333 without previous prostatic surgery, a statistically significant difference in margin localization was found. Moreover, we analyzed the 75 patients mentioned above, stratified in incidental PCa diagnosed at TURP or PCa detected with prostate biopsy for PSA rising during the post-TURP follow-up: no statistical differences were found between the 2 groups regarding margin status, even if PSM were more frequent in incidental PCa with no significance deriving from the stratification for PSM location at the apex or base. Conclusion: Men treated with TURP before RP presented an overall incidence of PSM similar to those without previous TURP, but with a higher risk of PSM at the bladder neck and a lower risk of PSM at the prostatic apex. Copyright © 2013 S. Karger AG, Basel.

Published
2013

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