Prostate news article, March 2008

POSITIVE MARGIN LENGTH MAY PREDICT PATIENT OUTCOME FOLLOWING RADICAL PROSTATECTOMY   Article reported by:   Professor Roger Kirby, Chairman, Prostate UK

According to a study published in the February 2008 issue of the journal Urology, "The length of positive margins (ie the area of the pathology specimen where the tumour is present at its extreme edges) predicts patient outcome after radical prostatectomy (RP) and should be included on pathology reports."

To reach this conclusion, researchers "reviewed the medical records of all men who had undergone RP at their institution between 1991 and 1999." The review identified 117 men who had positive margins and had not received additional neoadjuvant therapy, such as radiotherapy. To determine the length of the prostate margin, the researchers added together the lengths of all the areas of the tumour in contact with the inked surface (ie the edge of the removed prostate)."

While the overall progression-free survival (PFS) rate (ie complete cure) was 74.6 percent at follow-up, the researchers noticed that when they examined PFS in relation to the length of the positive margin they found that men with longer margins (>3.0 mm) had a significantly lower PFS than those with margins of 1.1-3.0 mm and those with margins <1.0 mm, at 52.4 percent, 80.2 percent, and 87.3 percent, respectively.

Furthermore, they found "that a longer positive margin was an independent predictor of poor patient prognosis, along with a Gleason score above eight, but not of the extension of tumour beyond the prostatic capsule."