ORIGINAL ARTICLE
Ahead of Print

Perineural invasion status, Gleason score and number of positive cores in biopsy pathology are predictors of positive surgical margin following laparoscopic radical prostatectomy


1 Department of Urology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China
2 Department of Urology, Nanjing Children's Hospital, Nanjing 210008, China
3 Department of Pathology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China

Correspondence Address:
Hong-Qian Guo,
Department of Urology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China

Xiao-Gong Li,
Department of Urology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China

Login to access the Email id

Source of Support: None, Conflict of Interest: None

This study was designed to define possible preoperative predictors of positive surgical margin after laparoscopic radical prostatectomy. We retrospectively analyzed the records of 296 patients with prostate cancer diagnosed by prostate biopsy, and eventually treated with laparoscopic radical prostatectomy. The prognostic impact of age, prostate volume, preoperative prostate-specific antigen, biopsy Gleason score, maximum percentage tumor per core, number of positive cores, biopsy perineural invasion, capsule invasion on imaging, and tumor laterality on surgical margin was assessed. The overall positive surgical margin rate was 29.1%. Gleason score, number of positive cores, perineural invasion, tumor laterality in the biopsy specimen, and prostate volume significantly correlated with risk of positive surgical margin by univariate analysis (P < 0.05). Gleason score (odds ratio [OR] = 2.286, 95% confidence interval [95% CI] = 1.431-3.653, P = 0.001), perineural invasion (OR = 4.961, 95% CI = 2.656-9.270, P < 0.001), and number of positive cores (OR = 4.403, 95% CI = 1.878-10.325, P = 0.001) were independent predictors of positive surgical margin at the multivariable logistic regression analysis. Patients with perineural invasion, higher biopsy Gleason scores and/or a large number of positive cores in biopsy pathology had more possibility of capsule invasion. The positive surgical margin rate in patients with capsule invasion (49.5%) was much higher than that with localized disease (17.8%). In contrast, prostate volume showed a protective effect against positive surgical margin (OR = 0.572, 95% CI = 0.346-0.945, P = 0.029). Gleason score, perineural invasion, and number of positive cores in the biopsy specimen were preoperative independent predictors of positive surgical margin after laparoscopic radical prostatectomy while prostate volume was a protective factor against positive surgical margin.


[FULL TEXT] [PDF]
Print this article
Search
 Back
 
  Search Pubmed for
 
    -  Yang R
    -  Cao K
    -  Han T
    -  Zhang YF
    -  Zhang GT
    -  Xu LF
    -  Lian HB
    -  Li XG
    -  Guo HQ
 Citation Manager
 Article Access Statistics
 Reader Comments
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed1236    
    PDF Downloaded84    

Recommend this journal