The significance of a positive bladder neck margin after radical prostatectomy: the American Joint Committee on Cancer Pathological Stage T4 designation is not warranted

The Journal of Urology
Phillip M PierorazioAlan W Partin

Abstract

The American Joint Committee on Cancer currently designates invasion of the bladder neck as a pT4 lesion. However, retrospective analyses have not demonstrated biochemical recurrence-free survival after radical prostatectomy to be consistent with other T4 lesions. We examined biochemical recurrence-free survival and cancer specific survival in men with a positive bladder neck margin. Of nearly 17,000 patients in the Johns Hopkins Institutional radical prostatectomy database (1982 to 2008) 198 (1.2%) were identified with a positive bladder neck margin. Kaplan-Meier analyses were used to evaluate biochemical recurrence-free survival and cancer specific survival. A multivariate proportional hazards model predicting biochemical recurrence-free survival and cancer specific survival was fit with prostate specific antigen, Gleason sum and pathological stage to determine the significance of a positive bladder neck margin. Of the 198 men with a positive bladder neck margin 79 had an isolated bladder neck margin without seminal vesicle or lymph node involvement. The 12-year biochemical recurrence-free survival of men with organ confined disease, extraprostatic extension, seminal vesicle invasion and lymph node involvement without a posit...Continue Reading

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Citations

Nov 8, 2014·Indian Journal of Urology : IJU : Journal of the Urological Society of India·Jonathan L Silberstein, James A Eastham
Oct 16, 2012·Seminars in Diagnostic Pathology·Adeboye O Osunkoya, David J Grignon
Jan 17, 2012·Urologic Oncology·Joshua J Meeks, James A Eastham
Jan 4, 2012·Histopathology·Liang ChengDaniel M Berney
Oct 30, 2014·Clinical & Translational Oncology : Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico·C A OtonS Moral
Dec 3, 2014·Clinical Genitourinary Cancer·Kosj YamoahPriti Lal
Jan 4, 2018·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·David J Grignon

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