Gleason pattern 4 or 5 prostate cancer at a positive surgical margin (PSM) following robot-assisted radical prostatectomy predicts early biochemical recurrence (BCR) of disease, according to study findings presented at the 34th Annual European Association of Urology Congress in Barcelona, Spain.
The study, by Jacques Planas, MD, PhD, and colleagues at the Universitat Autònoma de Barcelona, included 429 men who underwent robot-assisted radical prostatectomy. On multivariate analysis, patients found to have Gleason grade 4 or 5 at surgical margins had a significant 69% higher risk of early BCR (less than 12 months after surgery) compared with Gleason grade 3 at the margins. In addition, patients with International Society of Urologic Pathology (ISUP) specimen grade 3 or higher disease had a significant 77% increased risk of early BCR compared with those who had specimen ISUP grade 1 or 2.
Of the 429 men, 141 (32.8%) had PSM. At a median follow-up of 31.5 months, 17% of these patients experienced early BCR.
The authors commented that Gleason grade at the site of a PSM should aid in stratification of patients for adjuvant radiation therapy.
Planas J, Celma A, Regis L, et al. Gleason pattern 4 or 5 at a positive surgical margin predicts early biochemical recurrence (<12 months) after robotic radical prostatectomy. Presented at the 34th Annual European Association of Urology Congress in Barcelona, Spain, March 15 to 19.