Length of positive surgical margins after radical prostatectomy: Does size matter? - A systematic review and meta-analysis

被引:10
作者
John, Athul [1 ,2 ]
Lim, Alicia [1 ,2 ]
Catterwell, Rick [1 ,2 ]
Selth, Luke [1 ,3 ]
O'Callaghan, Michael [1 ,3 ,4 ]
机构
[1] Univ Adelaide, Fac Hlth & Med Sci, Adelaide Med Sch, Adelaide, SA, Australia
[2] Cent Adelaide Local Hlth Network, Urol, Adelaide, SA, Australia
[3] Flinders Univ S Australia, Flinders Hlth & Med Res Inst FHMRI, Coll Med & Publ Hlth, Freemasons Ctr Male Hlth & Wellbeing, Adelaide, SA, Australia
[4] Southern Adelaide Local Hlth Network, South Australia Prostate Canc Clin Outcomes Collab, Urol, Adelaide, SA, Australia
关键词
PRIMARY GLEASON GRADE; BIOCHEMICAL RECURRENCE; PROGNOSTIC-SIGNIFICANCE; INTERNATIONAL-SOCIETY; EXTENT; CANCER; IMPACT; TUMOR; RISK; PROGRESSION;
D O I
10.1038/s41391-023-00654-6
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
ObjectivesThe prognostic capacity of positive surgical margins (PSM) for biochemical recurrence (BCR) is unclear, with inconsistent findings across published studies. We aimed to systematically review and perform a meta-analysis exploring the impact of Positive surgical margin length on biochemical recurrence in men after radical prostatectomy.MethodsA search was conducted using the MEDLINE, Scopus, Embase and Cochrane databases according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The quality of the studies was assessed using the Newcastle-Ottawa scale, and the protocol was registered in advance (PROSPERO: CRD42020195908). This meta-analysis included 16 studies with BCR as the primary outcome measure.ResultsStudies used various dichotomised thresholds for PSM length. A subgroup meta-analysis was performed using the reported multivariable hazard ratio (Continuous, 3, and 1 mm PSM length). PSM length (continuous) was independently associated with an increased risk of BCR (7 studies, HR 1.04 (CI 1.02-1.05), I-2 = 8% p < 0.05). PSM length greater than 3 mm conferred a higher risk of BCR compared to less than 3 mm (4 studies, HR 1.99 (1.54-2.58) I-2 = 0%, p < 0.05). There was also an increased risk of BCR associated with PSM length of less than 1 mm compared to negative surgical margins (3 studies, HR 1.46 (1.05-2.04), I-2 = 0%, P = 0.02).ConclusionPSM length is independently prognostic for BCR after radical prostatectomy. Further long-term studies are needed to estimate the impact on systemic progression.
引用
收藏
页码:673 / 680
页数:8
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