Article thumbnail

Predictive Value of Positive Surgical Margins after Radical Prostatectomy for Lymph Node Metastasis in Locally Advanced Prostate Carcinoma

By Wolfgang Otto, Peter Gerber, Wolfgang Rößler, Wolf F. Wieland and Stefan Denzinger


Introduction. Suspected locally advanced prostate carcinoma shows lymph node involvement in a high percentage of cases. For a long time, such patients were not radically prostatectomised. In recent years, however, this viewpoint has changed. Material and Methods. We analysed a single-centre series of 34 patients with suspected locally advanced prostate cancer to establish predictive parameters for lymph node metastasis. All patients underwent radical prostatectomy between 2007 and 2010. Results. Of the 34 patients, 26% showed pathological stage T3a, 59% pT3b, and 15% pT4. Median preoperative PSA level was 25 ng/mL, and five patients had had neoadjuvant antihormonal treatment. Positive margins were found in 76% of patients. Patients without neoadjuvant treatment showed it in 79%, and after preoperative antihormonal treatment the rate was 60%. Positive margins were associated with lymph node involvement in 85% of cases, complete resection was associated only in 50% of cases. Conclusions. Positive surgical margins play an important predictive role when estimating lymph node involvement in patients with locally advanced prostate carcinoma. Neoadjuvant antihormonal therapy is associated with a relevant reduction in the rate of positive margins but not with the rate of lymph node metastasis. As such, a combination of antihormonal and surgical treatment should be considered

Topics: Research Article
Publisher: Hindawi Publishing Corporation
OAI identifier:
Provided by: PubMed Central

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.

Suggested articles


  1. (2007). Is radical prostatectomy feasible in all cases of locally advanced non-bone metastatic prostate cancer? Results of a single-institution study,”
  2. (2010). Long-term outcome of patients with high-risk prostate cancer following radical prostatectomy and stage-dependent adjuvant androgen deprivation,”
  3. (2009). Longterm follow-up of patients with prostate cancer and nodal metastases treated by pelvic lymphadenectomy and radical prostatectomy: the positive impact of adjuvant radiotherapy,”
  4. (2010). Outcome predictors of radical prostatectomy in patients with prostate-specific antigen greater than 20ng/ml: a European multi-institutional study of 712 patients,”
  5. Predicting pelvic lymph node involvement in current-era prostate cancer,” International Journal of Radiation Oncology.
  6. (1994). Predicting the risk of lymph node involvement using the pre-treatment prostate specific antigen and Gleason Score in men with clinically localized prostate cancer,”
  7. Prognostic significance of positive surgical margins after radical prostatectomy among pT2 and pT3a prostate cancer,” Urologic Oncology.
  8. (2011). Radical prostatectomy outcome when performed with PSA above 20ng/ml,”
  9. (1999). Radical retropubic prostatectomy plus orchiectomy versus orchiectomy alone for pTxN+ prostate cancer: a matched comparison,”
  10. (2010). Survival benefit of radical prostatectomy in lymph node-positive patients with prostate cancer,”
  11. Tombal et al., “Is there a prostatespecific antigen upper limit for radical prostatectomy?”