%0 Journal Article
%T Valor de los m¨¢rgenes quir¨²rgicos de resecci¨®n positivos en los pacientes con c¨¢ncer de pr¨®stata pT2: Implicaciones en el tratamiento adyuvante
%A Rosas-Nava
%A J.E.
%A Herranz-Amo
%A F.
%A Pa£¿os-Fagundo
%A E.V.
%A Lled¨®-Garc¨ªa
%A E.
%A Verd¨²-Tartajo
%A F.
%A Hern¨¢ndez-Fern¨¢ndez
%A C.
%J Actas Urol¨®gicas Espa£¿olas
%D 2011
%I Scientific Electronic Library Online
%R 10.4321/S0210-48062011000500004
%X objective: to analyse the impact on the recurrence-free biochemical survival of tumour involvement of surgical resection margins in patients with localized prostate cancer (pt2) in the prostatectomy specimen and its implications for adjuvant treatment. materials and method: retrospective study of 536 patients with stage pt2 prostate cancer, treated with radical prostatectomy between 1996 and 2007. subsequent to the prostatectomy, the following variables were collected: gleason score, pathological stage, capsular invasion, surgical margins and perineural invasion. we performed a univariate analysis and subsequently adjusted it by means of a cox proportional hazard model (enter method). results: 21.7% presented positive surgical margins and 20.9% developed biochemical recurrence after a mean follow-up of 57 months. 37.9% of the patients with pathological involvement of the resection surgical margins presented biochemical recurrence against 16% that did not have it (p<0.001). in the multivariate analysis, only the surgical margin (p<0.001) and the gleason score greater or equal to 8 (p<0.001) behaved as independent biochemical recurrence factors. on stratifying the series according to these two variables, we found that the patients with positive surgical margins and a gleason score of < 7 have a recurrence probability at 5 and 10years of 35% and 50% against 74% and 87% in the group with positive surgical margins and a gleason score of > 8 (p=0.002). conclusion: patients with pt2 prostate cancer, positive surgical margins and a gleason score of > 8 will benefit from adjuvant radiotherapy. 50% of the patients with positive margins and a gleason score of < 7 will not recur, which means that the indication of adjuvant radiotherapy continues to be controversial.
%K prostate cancer
%K radical prostatectomy
%K pt2 stage
%K prognostic factors
%K recurrence
%K positive surgical margins
%K adjuvant radiotherapy.
%U http://scielo.isciii.es/scielo.php?script=sci_abstract&pid=S0210-48062011000500004&lng=en&nrm=iso&tlng=en