Rapid communicationBenign prostatic glands at surgical margins of radical prostatectomy specimens: frequency and associated risk factors☆
Section snippets
Material and methods
The present study was part of a prospective study examining the usefulness of whole-mount processing of radical prostatectomy specimens and was performed with Institutional Review Board approval.4 One hundred nineteen consecutive whole-mount radical prostatectomy specimens were used for this study. Twelve men from this study group had received neoadjuvant treatment with androgen deprivation. The prostate glands were received fresh from the operating room, weighed, inked, and fixed overnight in
Results
A detailed summary with the preoperative patient demographics and pathologic analysis results for the 119 consecutive whole-mount radical prostatectomy specimens used for this study are presented in Table I. Thirteen (11%) of 119 cases had some evidence of benign glands on the inked surgical margins. Of these 13 cases, 4 had tumor identified on the inked surgical margins. The remaining 9 cases (8% of 119) had benign glands on inked surgical margins without any evidence of tumor on the inked
Comment
In the present study, the presence of benign prostate glands on the surgical margins was infrequent and when positive, found to be focal. In 2 of 13 cases, more than three glands were identified. These findings differ from those reported by Djavan et al.,2 who found approximately 30% of radical prostatectomy specimens to have benign glands on the surgical margins. One major difference between the two studies is that Djavan et al. examined prostatectomy specimens from multiple institutions. Our
Conclusions
The presence of benign glands at the surgical margins was found infrequently in a consecutive series of whole-mount radical prostatectomies. Benign glands were typically found at the apex and were associated with a larger gland volume and a higher Gleason score, suggesting wider excision may have been necessary. We conclude that the presence of benign glands at the surgical margins is likely to be a rare cause of an elevated PSA level after radical prostatectomy.
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This study was supported by a grant from the Specialized Program of Research Excellence (SPORE) in Prostate Cancer, National Cancer Institute, grant CA69568.