PROSTATE CANCER IN APICAL SKELETAL MUSCLE OF RADICAL PROSTATECTOMY SPECIMENS IS NOT ASSOCIATED WITH BIOCHEMICAL RECURRENCE

You have accessJournal of UrologyProstate Cancer: Staging II1 Apr 2012367 PROSTATE CANCER IN APICAL SKELETAL MUSCLE OF RADICAL PROSTATECTOMY SPECIMENS IS NOT ASSOCIATED WITH BIOCHEMICAL RECURRENCE Samuel Washington, Anobel Odisho, Michael Bonham, Peter Carroll, and Jeffry Simko Samuel WashingtonSamuel Washington San Francisco, CA More articles by this author , Anobel OdishoAnobel Odisho San Francisco, CA More articles by this author , Michael BonhamMichael Bonham San Francisco, CA More articles by this author , Peter CarrollPeter Carroll San Francisco, CA More articles by this author , and Jeffry SimkoJeffry Simko San Francisco, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.429AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In an effort to adequately resect cancer at the prostate, apex skeletal muscle may be found at the apical margins of radical prostatectomy specimens, an area without well-defined capsular borders. Staging becomes unclear when prostate cancer exists within skeletal muscle at the apex. Furthermore, the clinical significance of prostate cancer within skeletal muscle at the apical margin is largely unknown. We sought to determine whether presence of prostate cancer in apical skeletal muscle is associated with biochemical recurrence. METHODS Surgical specimens from men with clinical T1/2 disease who underwent RP at UCSF between 2004-2009 were re-reviewed by a single uropathologist, examining all sections from the prostate apex for the presence of skeletal muscle and cancer within the skeletal muscle. A cross-sectional analysis using Pearson chi-square statistics was used to evaluate the association between the cancer in apical skeletal muscle and biochemical recurrence within 84 months of follow-up. RESULTS Of the 936 specimens reviewed, 870 (93%) had skeletal muscle at the apical margin; 10% of this cohort (87/870) contained cancer within skeletal muscle. Mean follow-up was 30 months (SD 20 months). The majority had pathologic Gleason grade 3+4 (46%), 16% Gleason 4+3, and 4.5% Gleason 8-10 disease. Age at diagnosis, PSA at diagnosis and pathologic Gleason grade did not differ significantly between those with and without cancer in skeletal muscle (p>0.05 for all). Positive margins were present in 109 specimens (39% with cancer in skeletal muscle, 10% without, p<0.05). Rates of biochemical recurrence were not statistically significantly different between those with and without cancer in skeletal muscle (six with cancer in skeletal muscle, 33 without, p=0.3). When stratified by margin status, biochemical recurrence rates were not significantly different in those with and without cancer in skeletal muscle (10% vs 8% with positive margins, 7% vs 5% with negative margins, p>0.05 for all). CONCLUSIONS Prostate cancer in skeletal muscle at the apical margin, though significantly associated with positive margin status, is not independently associated with subsequent risk of biochemical recurrence. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e150-e151 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Samuel Washington San Francisco, CA More articles by this author Anobel Odisho San Francisco, CA More articles by this author Michael Bonham San Francisco, CA More articles by this author Peter Carroll San Francisco, CA More articles by this author Jeffry Simko San Francisco, CA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...