The Significance of Margin Involvement in Radical Prostatectomy Specimens for Presumed Localized Adenocarcinoma of Prostate in Relation to PSA (Biochemical) Failure Rate

Background: There is no clear cut way of predicting which patients would develop PSA failure after radical prostatectomy for localised prostate cancer. Aims: To investigate the hypothesis that pursuant to radical prostatectomy for localised prostate cancer, surgical margin involvement and non-involvement influence the PSA failure and non failure rate. Patients Materials and Methods: The Clinical records, laboratory results including histology reports, serum PSA levels, all radiological investigations and reports of our initial 50 consecutive patients who underwent radical prostatectomy were reviewed and outcome of the prostatectomy was recorded with regard to PSA failure or non failure as well as surgical margin involvement or non involvement by tumour. Analysis of outcome was done to ascertain the proportion of patients who developed PSA failure and non failure in both patients whose tumours involved the surgical margin and those without margin involvement. Statistical analyses were done using sure start to check if there is any significant difference in the outcome of both tumour groups Results: 5 patients out of 7 whose tumours were assessed to have involved the margin (71.42%) had PSA failure. 6 patients out of 43 whose tumours did not involve muscle (13.95%) developed PSA. The difference in outcome was statistically significant. Conclusions: Prostate cancers that involve the surgical margin at radical prostatectomy have a higher chance of developing PSA failure and should be treated with adjuvant therapy.