Radical prostatectomy with bladder neck preservation

Impact on positive margins

Fernando J. Bianco, David Grignon, Wael A. Sakr, Bijan Shekarriz, Jyoti Upadhyay, Eurico Dornelles, J. Edson Pontes

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Purpose: Bladder neck preservation during radical prostatectomy has been correlated with improved continence. However, the hazard of a positive margin at this specific site has discouraged many urologists. We evaluated if preservation of the bladder neck at the time of radical prostatectomy jeopardizes surgical cancer control with consequent deleterious outcomes. Materials and Methods: 675 consecutive patients underwent radical prostatectomy (RP) by a single surgeon (J.E.P.) at Wayne State University during the 1990s decade. The bladder neck was preserved. Margin-positivity was categorized by location and number. Preoperative, pathological and disease status data was prospectively collected into the Karmanos Cancer Institute multidisciplinary prostate cancer database. Results: Analysis was performed on 555 patients who had RP as monotherapy. Positive margins were found in 178 (32%) of these patients. Correlation between specimen Gleason score, prostatic specific antigen (PSA) and margin status, was encountered (p = 0.001). Apical and bladder neck margin-positivity was detected in 104/555 (19%) and 13/555 (2%), respectively. Of those specimens with a positive margin at the bladder neck eight had Gleason score ≥7, three had seminal vesicle invasion and two nodal disease. Only two patients had a positive bladder neck margin as the sole adverse pathological feature. Significant independent predictors of survival included the Gleason score, PSA, pathological stage and presence of positive margins in more than one location. Conclusions: Anatomical preservation of the bladder neck does not increase the percentage of positive margins at this anatomical location and does not compromise disease-free survival.

Original languageEnglish (US)
Pages (from-to)461-466
Number of pages6
JournalEuropean Urology
Volume43
Issue number5
DOIs
StatePublished - May 1 2003
Externally publishedYes

Fingerprint

Prostatectomy
Urinary Bladder
Neoplasm Grading
Antigens
Seminal Vesicles
Disease-Free Survival
Neoplasms
Prostatic Neoplasms
Databases
Survival

Keywords

  • Bladder neck preservation
  • PSA
  • Stage
  • Surgical margins
  • Survival

ASJC Scopus subject areas

  • Urology

Cite this

Bianco, F. J., Grignon, D., Sakr, W. A., Shekarriz, B., Upadhyay, J., Dornelles, E., & Pontes, J. E. (2003). Radical prostatectomy with bladder neck preservation: Impact on positive margins. European Urology, 43(5), 461-466. https://doi.org/10.1016/S0302-2838(03)00103-9

Radical prostatectomy with bladder neck preservation : Impact on positive margins. / Bianco, Fernando J.; Grignon, David; Sakr, Wael A.; Shekarriz, Bijan; Upadhyay, Jyoti; Dornelles, Eurico; Pontes, J. Edson.

In: European Urology, Vol. 43, No. 5, 01.05.2003, p. 461-466.

Research output: Contribution to journalArticle

Bianco, FJ, Grignon, D, Sakr, WA, Shekarriz, B, Upadhyay, J, Dornelles, E & Pontes, JE 2003, 'Radical prostatectomy with bladder neck preservation: Impact on positive margins', European Urology, vol. 43, no. 5, pp. 461-466. https://doi.org/10.1016/S0302-2838(03)00103-9
Bianco, Fernando J. ; Grignon, David ; Sakr, Wael A. ; Shekarriz, Bijan ; Upadhyay, Jyoti ; Dornelles, Eurico ; Pontes, J. Edson. / Radical prostatectomy with bladder neck preservation : Impact on positive margins. In: European Urology. 2003 ; Vol. 43, No. 5. pp. 461-466.
@article{2b67d123c4344eafa028ba5d6ec77228,
title = "Radical prostatectomy with bladder neck preservation: Impact on positive margins",
abstract = "Purpose: Bladder neck preservation during radical prostatectomy has been correlated with improved continence. However, the hazard of a positive margin at this specific site has discouraged many urologists. We evaluated if preservation of the bladder neck at the time of radical prostatectomy jeopardizes surgical cancer control with consequent deleterious outcomes. Materials and Methods: 675 consecutive patients underwent radical prostatectomy (RP) by a single surgeon (J.E.P.) at Wayne State University during the 1990s decade. The bladder neck was preserved. Margin-positivity was categorized by location and number. Preoperative, pathological and disease status data was prospectively collected into the Karmanos Cancer Institute multidisciplinary prostate cancer database. Results: Analysis was performed on 555 patients who had RP as monotherapy. Positive margins were found in 178 (32{\%}) of these patients. Correlation between specimen Gleason score, prostatic specific antigen (PSA) and margin status, was encountered (p = 0.001). Apical and bladder neck margin-positivity was detected in 104/555 (19{\%}) and 13/555 (2{\%}), respectively. Of those specimens with a positive margin at the bladder neck eight had Gleason score ≥7, three had seminal vesicle invasion and two nodal disease. Only two patients had a positive bladder neck margin as the sole adverse pathological feature. Significant independent predictors of survival included the Gleason score, PSA, pathological stage and presence of positive margins in more than one location. Conclusions: Anatomical preservation of the bladder neck does not increase the percentage of positive margins at this anatomical location and does not compromise disease-free survival.",
keywords = "Bladder neck preservation, PSA, Stage, Surgical margins, Survival",
author = "Bianco, {Fernando J.} and David Grignon and Sakr, {Wael A.} and Bijan Shekarriz and Jyoti Upadhyay and Eurico Dornelles and Pontes, {J. Edson}",
year = "2003",
month = "5",
day = "1",
doi = "10.1016/S0302-2838(03)00103-9",
language = "English (US)",
volume = "43",
pages = "461--466",
journal = "European Urology",
issn = "0302-2838",
publisher = "Elsevier",
number = "5",

}

TY - JOUR

T1 - Radical prostatectomy with bladder neck preservation

T2 - Impact on positive margins

AU - Bianco, Fernando J.

AU - Grignon, David

AU - Sakr, Wael A.

AU - Shekarriz, Bijan

AU - Upadhyay, Jyoti

AU - Dornelles, Eurico

AU - Pontes, J. Edson

PY - 2003/5/1

Y1 - 2003/5/1

N2 - Purpose: Bladder neck preservation during radical prostatectomy has been correlated with improved continence. However, the hazard of a positive margin at this specific site has discouraged many urologists. We evaluated if preservation of the bladder neck at the time of radical prostatectomy jeopardizes surgical cancer control with consequent deleterious outcomes. Materials and Methods: 675 consecutive patients underwent radical prostatectomy (RP) by a single surgeon (J.E.P.) at Wayne State University during the 1990s decade. The bladder neck was preserved. Margin-positivity was categorized by location and number. Preoperative, pathological and disease status data was prospectively collected into the Karmanos Cancer Institute multidisciplinary prostate cancer database. Results: Analysis was performed on 555 patients who had RP as monotherapy. Positive margins were found in 178 (32%) of these patients. Correlation between specimen Gleason score, prostatic specific antigen (PSA) and margin status, was encountered (p = 0.001). Apical and bladder neck margin-positivity was detected in 104/555 (19%) and 13/555 (2%), respectively. Of those specimens with a positive margin at the bladder neck eight had Gleason score ≥7, three had seminal vesicle invasion and two nodal disease. Only two patients had a positive bladder neck margin as the sole adverse pathological feature. Significant independent predictors of survival included the Gleason score, PSA, pathological stage and presence of positive margins in more than one location. Conclusions: Anatomical preservation of the bladder neck does not increase the percentage of positive margins at this anatomical location and does not compromise disease-free survival.

AB - Purpose: Bladder neck preservation during radical prostatectomy has been correlated with improved continence. However, the hazard of a positive margin at this specific site has discouraged many urologists. We evaluated if preservation of the bladder neck at the time of radical prostatectomy jeopardizes surgical cancer control with consequent deleterious outcomes. Materials and Methods: 675 consecutive patients underwent radical prostatectomy (RP) by a single surgeon (J.E.P.) at Wayne State University during the 1990s decade. The bladder neck was preserved. Margin-positivity was categorized by location and number. Preoperative, pathological and disease status data was prospectively collected into the Karmanos Cancer Institute multidisciplinary prostate cancer database. Results: Analysis was performed on 555 patients who had RP as monotherapy. Positive margins were found in 178 (32%) of these patients. Correlation between specimen Gleason score, prostatic specific antigen (PSA) and margin status, was encountered (p = 0.001). Apical and bladder neck margin-positivity was detected in 104/555 (19%) and 13/555 (2%), respectively. Of those specimens with a positive margin at the bladder neck eight had Gleason score ≥7, three had seminal vesicle invasion and two nodal disease. Only two patients had a positive bladder neck margin as the sole adverse pathological feature. Significant independent predictors of survival included the Gleason score, PSA, pathological stage and presence of positive margins in more than one location. Conclusions: Anatomical preservation of the bladder neck does not increase the percentage of positive margins at this anatomical location and does not compromise disease-free survival.

KW - Bladder neck preservation

KW - PSA

KW - Stage

KW - Surgical margins

KW - Survival

UR - http://www.scopus.com/inward/record.url?scp=0037629073&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037629073&partnerID=8YFLogxK

U2 - 10.1016/S0302-2838(03)00103-9

DO - 10.1016/S0302-2838(03)00103-9

M3 - Article

VL - 43

SP - 461

EP - 466

JO - European Urology

JF - European Urology

SN - 0302-2838

IS - 5

ER -