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Shulin Wu Sharron X. Lin Gregory J. Wirth Min Lu Jian Lu Alexander O. Subtelny Zongwei Wang Douglas M. Dahl Aria F. Olumi Chin-Lee Wu 《Clinical genitourinary cancer》2019,17(1):e44-e52
Objective
To assess the impact of focality and location of positive surgical margins (PSM) on long-term outcomes after radical prostatectomy (RP) for prostate cancer (PCa), including biochemical recurrence (BCR), metastasis and overall mortality.Patients and Methods
From a total of 2796 cases of RP between 1993 and 2007 in our single hospital, 476 cases with PSMs were identified and included in this study. PSM location was categorized into apex, peripheral, and bladder neck. Survival was estimated using the Kaplan-Meier method. Cox proportional hazard regression models were used to analyze the impact of PSM focality and location status on oncologic survival.Results
Of these 476 cases with PSMs, 335 (70.4%) cases were with single focal (sF) PSMs and 141 (29.6%) cases were with multifocal (mF) PSMs. Furthermore, 406 (85.3%) cases were found to have single location (sL) PSMs, and 70 (14.7%) cases were with multilocation (mL) PSMs. The median follow-up was 12.9 years. mF-PSMs and mL-PSMs showed significant impact on increased BCR risk on univariate analysis, and mL-PSMs remained significant on multivariate analysis (P = .048). Furthermore, the combination of multifocality and multilocation showed added prognostic value on predicting BCR-free survival, but not on metastasis-free survival or overall survival.Conclusion
The presence of mF-PSMs and mL-PSMs, and especially the combination of both, demonstrated significant impact on BCR prognosis. Patients with apex sLsF-PSMs were less likely to have BCR when compared with all those with non-apex sLsF-PSMs. These results should be considered when evaluating patients for adjuvant therapy. 相似文献995.
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Cerebrospinal fluid (CSF) beta 2-microglobulin (beta 2-MG) level was measured in 72 healthy subjects and the value (means +/- S means) was found to be 1.26 +/- 0.06 mg/L. The CSF beta 2-MG level in 33 patients who had simple acute leukemia without CNS involvement was 1.46 +/- 0.13 mg/L, which was not significantly different from that in the normal controls (P greater than 0.05). In 25 patients who had leukemia with involvement of CNS, the CSF beta 2-MG level (mean +/- S mean) was 3.94 +/- 0.30 mg/L, which was statistically different from that in the healthy controls (P less than 0.01). It is found that beta 2-MG level in CSF was one of the reliable criteria for diagnosis and indication of intrathecal chemotherapy in CNS leukemia. 相似文献
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