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Primary Gleason Grade 4 at the Positive Margin Is Associated with Metastasis and Death Among Patients with Gleason 7 Prostate Cancer Undergoing Radical Prostatectomy

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Viers B.R., Sukov W.R., Gettman M.T., Rangel L.J., Bergstralh E.J., Frank I., Tollefson M.K., Thompson R.H., Boorjian S.A., Karnes R.J.

European Urology 2014 

Background: The presence of a positive surgical margin (PSM) at radical prostatectomy (RP) has been linked to an increased risk of biochemical recurrence and receipt of secondary therapy; however, its association with other oncologic end points remains controversial. Objective: To evaluate the association of primary Gleason grade (GG) at the site of PSM with subsequent clinical progression and mortality among patients with Gleason score (GS) 7 prostate cancer (PCa). Design, setting, and participants: We identified 1036 patients who underwent RP between 1996 and 2002. A single uropathologist re-reviewed all specimens noted to have a PSM to record GG at the margin. Outcome measurements and statistical analysis: Survival was estimated using the Kaplan-Meier method. Cox models were used to analyze the association of margin primary GG with outcome…(ver más)

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