Long-term oncological outcomes of apical positive surgical margins at radical prostatectomy in the Shared Equal Access Regional Cancer Hospital cohort

Abstract

In a large cohort of men undergoing RP, those with PSMs at the prostatic apex had lower BCR, metastases, or PCa death compared with those with PSMs at other locations. When adjusted for pathologic stage and grade, however, PSMs were associated with BCR but not long-term oncologic outcomes. These data confirm that men with apex-only PSMs may not be ideal candidates for adjuvant therapy after RP.

Radical prostatectomy and the effect of close surgical margins: results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database

“…Although guidelines currently recommend adjuvant therapy should be offered for all men with PSM, the long‐term implications of PSM remain elusive. Consistent with a previously published study from SEARCH, PSM were not an independent risk factor for the development of castrate‐resistant prostate cancer, metastasis, or death . Although the present study included more men, the results were the same.…”

“…After obtaining Institutional Review Board approval, patients treated with RP between 1988 and 2015 at Veteran's Affairs medical centres in San Diego, West Los Angeles, and Palo Alto, California; Augusta, Georgia; and Asheville and Durham, North Carolina were collected and combined into the Shared Equal Access Regional Cancer Hospital (SEARCH) database . Patients treated with preoperative androgen‐deprivation therapy (ADT) or RT were excluded in the SEARCH cohort.…”

Obesity, risk of biochemical recurrence, and prostate‐specific antigen doubling time after radical prostatectomy: results from the SEARCH database

“…Clinic notes were reviewed to collect outside PSA data. Among all the men, the median (interquartile range) number of postoperative PSA tests was 14 (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21).…”

“…To test this hypothesis, we examined the association between body mass index (BMI) and aggressive BCR, using PSA doubling time (PSADT) as a measure of disease aggressiveness, given PSADT has been shown to correlate with PCSM [12]. To accomplish this, we used the multicentre, multi-ethnic Shared Equal Access Regional Cancer Hospital (SEARCH) database [13].…”

Timing of Prostate-specific Antigen Nadir After Radical Prostatectomy and Risk of Biochemical Recurrence

“…13 Patients operated before 1998 were not included in the study because ultrasensitive PSA assays were not available at all of our centers before 1998. An undetectable PSA was defined as a value <0.01 ng/mL.…”