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KMID : 1141320190340020095
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Kosin Medical Journal
2019 Volume.34 No. 2 p.95 ~ p.105
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Cribriform Pattern at the Surgical Margin is Highly Predictive of Biochemical Recurrence in Patients Undergoing Radical Prostatectomy
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Kim Kyung-Hwan
Ku Ja-Yoon
Lee Chan-Ho
Park Won-Young
Ha Hong-Koo
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Abstract
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Objectives: We investigated the relationship between cribriform patterns and biochemical recurrence in patients with pos-itive surgical margins after radical prostatectomy.
Methods: This study was based on radical prostatectomy specimens obtained from 817 patients (165 with margin-positive status) collected at a single center between 2010 and 2016. We retrospectively analyzed and compared body mass index, preoperative prostate-specific antigen, Gleason score, operative methods, postoperative Gleason score, pathological T-stage, tumor percentage involvement, lymphatic and perineural invasion, prostate-specific antigen nadir, location and length of the positive margin, cribriform pattern status, and Gleason grade at the surgical margin in terms of their associ-ation with biochemical recurrence. Risk factors for biochemical recurrence were also investigated.
Results: 21% (31/146) of surgical margin-positive patients had a cribriform pattern. Nadir prostate-specific antigen, per-ineural invasion and biochemical recurrence rates were significantly higher in cribriform pattern present group than absent group (P = 0.031, 0.043 and 0.045, respectively). According to the Cox regression model, postoperative Gleason score, tumor percentage involvement, location and length of the positive margin, and the presence of a cribriform pattern at the surgical margin were significant predictive factors of biochemical recurrence (P = 0.022, < 0.001, 0.015, 0.001, and 0.022, respectively). Moreover, the biochemical recurrence risk was approximately 3-fold higher in patients with a cribriform pattern at the surgical margin than in those without (HR: 3.41, 95% CI 1.20-9.70, P = 0.022).
Conclusions: A cribriform pattern at the surgical margin is a significant predictor of biochemical recurrence in patients who undergo radical prostatectomy.
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KEYWORD
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Prostatectomy, Prostate-specific antigen, Prostatic Neoplasms, Recurrence, Surgical margin
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