WHAT IS TO BE DONE IF THE MARGIN OF RESEC TION IS POSITIVE AFTER RADICAL PROSTATECTOMY

Citation
M. Wirth et al., WHAT IS TO BE DONE IF THE MARGIN OF RESEC TION IS POSITIVE AFTER RADICAL PROSTATECTOMY, Der Urologe, 37(2), 1998, pp. 135-137
Citations number
16
Categorie Soggetti
Urology & Nephrology
Journal title
ISSN journal
03402592
Volume
37
Issue
2
Year of publication
1998
Pages
135 - 137
Database
ISI
SICI code
0340-2592(1998)37:2<135:WITBDI>2.0.ZU;2-#
Abstract
In the last years radical retropubic prostatectomy has become the trea tment of choice for locally confined prostate cancer (PCa). However, i n the literature local recurrence is described in 4-23 % of patients w ith clinical stage T1-2 prostate cancer and in 43 % of patients with c linical stage T3 respectively. The problem is further aggravated that postoperatively raised PSA values are detected in 6-8 % of patients wi th locally confined prostate cancer indicating either local residual t umor or systemic disease. Current datas show that wait-and-watch appea rs to be the best option for patients with locally confined prostate c ancer and positive margins. In case of persistent or raising PSA-value s following prostatectomy without detectable local recurrence or metas tasis mere local therapy cannot be recommended. Primary radiotherapy s hould be considered in cases with confirmed clinical local recurrence without distant metastasis. Further prospective and randomized trials have to be initiated to identify the patients with positive margins wh o will benefit from adjuvant treatment.