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Clinical Utility of Subclassifying Positive Surgical Margins at Radical Prostatectomy by Shawn Dason; Emily A. Vertosick; Kazuma Udo; Daniel D. Sjoberg; Andrew J. Vickers; Hikmat Al‐Ahmadie; Ying‐Bei Chen; Anuradha Gopalan; S. Joseph Sirintrapun; Satish K. Tickoo; Peter T. Scardino; James A. Eastham; Victor E. Reuter; Samson W. Fine is a Medicine article available to read on EtoBox.
What is Clinical Utility of Subclassifying Positive Surgical Margins at Radical Prostatectomy about?
## Objective To determine whether subclassification of positive surgical margins (PSMs) increases predictive ability for biochemical recurrence (BCR) and aids clinical decision‐making in patients undergoing radical prostatectomy. ## Patients and Methods We studied 2147 patients with pT2 and pT3a prostate cancer with detailed surgical margin parameters and BCR status. We compared a base model, a linear predictor calculated from the Memorial Sloan Kettering Cancer Center postoperative nomogram (prostate‐specific antigen, pathological tumour grade and stage), with the addition of surgical margin status to five additional models (base model plus surgical margin subclassifications) to evaluate enhancement in predictive accuracy. Decision curve analysis (DCA) was performed to determine the clinical utility of parameters that enhanced predictive accuracy. ## Results Among 2147 men, 205 had PSMs, and 231 developed BCR. Discrimination for the base model with addition of surgical margin status was high (c‐index = 0.801) and not meaningfully improved by adding surgical margin subclassification in the full cohort. In analyses considering only men with PSMs (N = 55 with BCR), adding surgical ma
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- Author
- Shawn Dason; Emily A. Vertosick; Kazuma Udo; Daniel D. Sjoberg; Andrew J. Vickers; Hikmat Al‐Ahmadie; Ying‐Bei Chen; Anuradha Gopalan; S. Joseph Sirintrapun; Satish K. Tickoo; Peter T. Scardino; James A. Eastham; Victor E. Reuter; Samson W. Fine
- Publisher
- Wiley
- Published
- 2021
- Language
- EN
- Field
- Medicine (Health Sciences)