XXXX threatening or affecting the prostatic plane: is partial prostatectomy oncologically adequate? Results of a multicentre retrospective study.

@entity5 @entity1 @entity16 @entity1069
AIM: The management of @entity5 threatening or affecting the prostatic plane is still under debate. The role of the preoperative chemo-radiotherapy and the extent of prostatectomy seem to be key-points in the treatment of these @entity5 . The aim of the present study was to evaluate the pathological circumferential margin status and the local recurrence rate following different therapeutic options. METHOD: A multicentre, retrospective study was conducted of @entity1 with @entity5 threatening or affecting the prostatic plane judged by magnetic resonance imaging (MRI). The use of preoperative chemoradiotherapy and the type of urologic resection were correlated with the status of the pathological circumferential resection margin (CRM) and local recurrence. RESULTS: A consecutive series of 126 males with @entity5 threatening (44) or affecting (82) the prostatic plane on preoperative staging and operated with local curative intent between 1998-2010 was analysed. In @entity1 who did not have chemoradiotherapy but a threatened anterior margin the CRM positive rate was 25.0%. In @entity1 having no preoperative chemoradiotherapy who had an affected margin, the rate was 41.7%. When preoperative radiotherapy was given, the respective CRM infiltration rates were 7.1% and 20.7%. In @entity1 having preoperative chemoradiotherapy followed by prostatic resection the rate of CRM positivity was 2.4%. Partial prostatectomy after preoperative chemo-radiotherapy resulted in a free anterior circumferential resection margin in all cases, but intraoperative @entity16 occurred in 36.4% of the @entity1 who underwent partial prostatectomy, resulting in a postoperative urinary fistula in 18.2% of @entity1 . CONCLUSION: preoperative chemoradiation is mandatory in male @entity1 with a threatened or affected anterior circumferential margin on preoperative MRI. In @entity1 with preoperative @entity1069 , prostatic resection is necessary. In this group of @entity1 partial prostatectomy seems to be oncologically safe. This article is protected by copyright. All rights reserved.
