Positive surgical margins after radical prostatectomy: Does it matter?

摘要

After decades of study, it remains difficult to accurately quantify the incidence or prevalence of positive surgical margins (PSMs) after radical prostatectomy (RP). Reported percentages of PSMs vary greatly (range: 1% to >50%) depending on whether the prostate cancer (PCa) was organ confined (pT2) or not (pT3+) [1 ]. This is due to a multitude of factors including varying definitions of PSMs, changing pathologic specimen handling and reporting, innovative surgical techniques, stage migration due to prostate-specific antigen testing, and publication bias whereby rates of pT2 or pT3 PSMs reported by high-volume centers of excellence may not be representative of levels seen at the population level. For example, published rates of pT2 PSMs range from 1.3% to 24.2%, whereas a population-based study from Ontario, Canada, found the rate to be 33% [2,3].