Do Length and Tumor Grades of Positive Surgical Margin Have an Impact on Biochemical Recurrence After Prostatectomy?

Objective: Biochemical recurrence (BCR) does not occur in all patients with surgical margin (SM) positivity after radical prostatectomy (RP). The aim of our study is to evaluate the effect of additional features such as length, extent and Gleason grade on BCR in the positive SM determined in patients undergoing RP in our clinic.\udMaterials and Methods: Clinicopathologic data and SM characteristics of 56 patients with pathologic stages of pT2-3aN0M0 and surgical border positivity were recorded from patients admitted to our RP database with retropublic RP between August 2001 and January 2015 and their relationship with BCR was evaluated statistically.\udResults: The median follow-up time of the patients was 39.4 (13-208) months. BCR was detected in 17 (30.3%) of the patients. Prostate specific antigen levels, tumor volumes and tumor percentages were found significantly higher in the patients with BCR (p<0.05). In the BCR group, focal SM positivity was found statistically less frequent compared with the disease-free follow-up group (47.1% and 94.9% respectively; p<0.001). There was no statistically significant relationship between BCR both surgical margin Gleason grade (SMGG) and SM length (p>0.05). According to the Kaplan-Meier survival analysis, the relationship between SMGG and the time of BCR was statistically significant (p=0.04). In SMGG 5 patients, the duration of BCR development was found significantly shorter. According to multivariable Cox regression analysis none of the factors were found to be effective on BCR (p>0.05).\udConclusion: SM positivity is one of the important factors for BCR. However, patients with positive SMs are quite heterogeneous and it is obvious that not all patients should be treated in the same way. It is wise to assess adjunctive SM features such as SM, length, Gleason score and grade, and decide according to the patients’ risk groups to decide on adjuvant treatment