Narrative review of principles of salvage radical prostatectomy

May, Danica; Parker, William P.

doi:10.21037/amj-20-60

Cited by 1 publication

(1 citation statement)

References 24 publications

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“…EBRT plus androgen deprivation therapy (ADT) or EBRT + brachytherapy +/− ADT are alternative options for these patients (+/− docetaxel for very high-risk patients). Salvage radical prostatectomy may also be performed for patients with biochemical recurrence after initial EBRT, but morbidity is significant in this setting [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Radical or Not-So-Radical Prostatectomy: Do Surgical Margins Matter?

Grypari

Zolota

Tzelepi

2021

Cancers

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Prostate cancer is the second most common malignancy in men, and prostatectomy is the treatment of choice for most patients with at least low risk of progression. The presence of positive margins in the radical prostatectomy specimen is considered an adverse pathologic feature, and may prompt additional therapeutic intervention in the patients. The absence of a distinct capsule around the prostate and intraoperative manipulations that aim to minimize postoperative adverse effects, complicate its wide removal. Proper handling of the specimen during the gross processing is essential for accurate determination of the status of margins or resection. Positive margins, defined as the presence of neoplastic glands in the highlighted-with-ink margin of resection, range from 6–38%. The surgical technique, surgeon’s expertise and tumor (i.e., grade and stage) and patients’ (i.e., BMI) characteristics affect the rate of margin positivity. Extensive or multifocal and nonanterior/nonapical positive margins are linked with higher recurrence rates, especially in organ-confined disease, underscoring the need for treating these patients more aggressively. In summary, detailed description of the status of the margins should be performed in every pathology report to determine patients’ prognosis and the most appropriate therapeutic plan.

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Section: Introductionmentioning

confidence: 99%