Is a Positive Bladder Neck Margin Truly a T4 Lesion in the Prostate Specific Antigen Era? Results From the SEARCH Database

W. Cooper Buschemeyer, Robert J. Hamilton, William J. Aronson, Joseph C. Presti, Martha K. Terris, Christopher J. Kane, Christopher Amling, Stephen J. Freedland

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Purpose: Positive bladder neck margins after radical prostatectomy are currently designated as pT4 lesions. However, to our knowledge the prognostic significance of a positive bladder neck margin in the prostate specific antigen era is unknown. We examined the association between positive bladder neck margins and prostate specific antigen recurrence relative to other pathological findings. Materials and Methods: We examined 1,722 men from the Shared Equal Access Research Cancer Hospital Database who were treated with radical prostatectomy without lymph node metastases. Time to prostate specific antigen recurrence was compared in men with positive vs negative bladder neck margins using Cox proportional hazards models adjusted for multiple clinical and pathological features. Results: A positive bladder neck margin in 79 patients (5%) was significantly associated with other poor prognostic features, including higher prostate specific antigen, higher pathological Gleason sum, extracapsular extension, seminal vesicle invasion and other positive margins. After adjusting for clinical and pathological characteristics positive bladder neck margins were associated with an increased risk of prostate specific antigen recurrence (HR 1.52, 95% CI 1.06-2.19, p = 0.02). Relative to organ confined margin negative disease a positive bladder neck margin associated with other positive margins showed a recurrence risk that was similar to that of seminal vesicle invasion (HR 4.14, 95% CI 2.55-6.73 and HR 4.22, 95% CI 3.08-5.78, respectively, each p

Original languageEnglish (US)
Pages (from-to)124-129
Number of pages6
JournalJournal of Urology
Volume179
Issue number1
DOIs
StatePublished - Jan 2008
Externally publishedYes

Fingerprint

Prostate-Specific Antigen
Urinary Bladder
Databases
Recurrence
Seminal Vesicles
Prostatectomy
Cancer Care Facilities
Proportional Hazards Models
Lymph Nodes
Neoplasm Metastasis
Research

Keywords

  • bladder
  • neoplasm staging
  • prostate
  • prostatectomy
  • prostatic neoplasms

ASJC Scopus subject areas

  • Urology

Cite this

Buschemeyer, W. C., Hamilton, R. J., Aronson, W. J., Presti, J. C., Terris, M. K., Kane, C. J., ... Freedland, S. J. (2008). Is a Positive Bladder Neck Margin Truly a T4 Lesion in the Prostate Specific Antigen Era? Results From the SEARCH Database. Journal of Urology, 179(1), 124-129. https://doi.org/10.1016/j.juro.2007.08.130

Is a Positive Bladder Neck Margin Truly a T4 Lesion in the Prostate Specific Antigen Era? Results From the SEARCH Database. / Buschemeyer, W. Cooper; Hamilton, Robert J.; Aronson, William J.; Presti, Joseph C.; Terris, Martha K.; Kane, Christopher J.; Amling, Christopher; Freedland, Stephen J.

In: Journal of Urology, Vol. 179, No. 1, 01.2008, p. 124-129.

Research output: Contribution to journalArticle

Buschemeyer, WC, Hamilton, RJ, Aronson, WJ, Presti, JC, Terris, MK, Kane, CJ, Amling, C & Freedland, SJ 2008, 'Is a Positive Bladder Neck Margin Truly a T4 Lesion in the Prostate Specific Antigen Era? Results From the SEARCH Database', Journal of Urology, vol. 179, no. 1, pp. 124-129. https://doi.org/10.1016/j.juro.2007.08.130
Buschemeyer, W. Cooper ; Hamilton, Robert J. ; Aronson, William J. ; Presti, Joseph C. ; Terris, Martha K. ; Kane, Christopher J. ; Amling, Christopher ; Freedland, Stephen J. / Is a Positive Bladder Neck Margin Truly a T4 Lesion in the Prostate Specific Antigen Era? Results From the SEARCH Database. In: Journal of Urology. 2008 ; Vol. 179, No. 1. pp. 124-129.
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