[Impact of positive surgical margins on prostate cancer prognosis]

Abstract

Objective: To examine the impact of positive surgical margins (PSM) after radical prostatectomy (RP) for prostate cancer on oncological results.

Patients and methods: We performed a study where all patients who underwent radical prostatectomy between January 2004 and December 2018 for prostate cancer were included. The preoperative, postoperative data and the carcinological results collected were analyzed. Data were analysed using Kaplan-Meier survival analysis and proportional hazards models.

Results: A total of 319 patients with a median age of 65 years (IQR : 62-69) were included. The median follow-up was 43.6 months (IQR: 19.4-79.3). The overall rate of PSM was 33.5%. PSM was associated with biochemical recurrence (P<0.001). Overall mortality was not associated with positive margins. A clinical stage> T1c was an independent predictor of PSM on multivariate analysis (P=0.01).

Conclusion: PSM would increase the risk of biochemical recurrence with no impact on survival. Clinical stage>T1c was an adverse predictor for PSM.

Level of evidence: 3.

Keywords: Biochemical recurrence; Cancer de prostate; Marges chirurgicales positives; Positive surgical margins; Prostate neoplasms; Prostatectomie totale; Radical Prostatectomy; Récidive biochimique; Survie; Survival.