Difference between revisions of "Prostate gland"

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725 bytes added ,  23:22, 7 October 2012
(→‎Surgical margins: +significance)
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*Norway: 26% -- strong dependence on surgeon volume (18% high case load vs. 44% low case load).<ref name=pmid22860630>{{Cite journal  | last1 = Steinsvik | first1 = EA. | last2 = Axcrona | first2 = K. | last3 = Angelsen | first3 = A. | last4 = Beisland | first4 = C. | last5 = Dahl | first5 = A. | last6 = Eri | first6 = LM. | last7 = Haug | first7 = ES. | last8 = Svindland | first8 = A. | last9 = Fosså | first9 = S. | title = Does a surgeon's annual radical prostatectomy volume predict the risk of positive surgical margins and urinary incontinence at one-year follow-up? - Findings from a prospective national study. | journal = Scand J Urol Nephrol | volume =  | issue =  | pages =  | month = Aug | year = 2012 | doi = 10.3109/00365599.2012.707684 | PMID = 22860630 }}</ref>
*Norway: 26% -- strong dependence on surgeon volume (18% high case load vs. 44% low case load).<ref name=pmid22860630>{{Cite journal  | last1 = Steinsvik | first1 = EA. | last2 = Axcrona | first2 = K. | last3 = Angelsen | first3 = A. | last4 = Beisland | first4 = C. | last5 = Dahl | first5 = A. | last6 = Eri | first6 = LM. | last7 = Haug | first7 = ES. | last8 = Svindland | first8 = A. | last9 = Fosså | first9 = S. | title = Does a surgeon's annual radical prostatectomy volume predict the risk of positive surgical margins and urinary incontinence at one-year follow-up? - Findings from a prospective national study. | journal = Scand J Urol Nephrol | volume =  | issue =  | pages =  | month = Aug | year = 2012 | doi = 10.3109/00365599.2012.707684 | PMID = 22860630 }}</ref>
*France: 13-17%.<ref name=pmid22860572>{{Cite journal  | last1 = Koutlidis | first1 = N. | last2 = Mourey | first2 = E. | last3 = Champigneulle | first3 = J. | last4 = Mangin | first4 = P. | last5 = Cormier | first5 = L. | title = Robot-assisted or pure laparoscopic nerve-sparing radical prostatectomy: What is the optimal procedure for the surgical margins? A single center experience. | journal = Int J Urol | volume =  | issue =  | pages =  | month = Jul | year = 2012 | doi = 10.1111/j.1442-2042.2012.03102.x | PMID = 22860572 }}</ref>
*France: 13-17%.<ref name=pmid22860572>{{Cite journal  | last1 = Koutlidis | first1 = N. | last2 = Mourey | first2 = E. | last3 = Champigneulle | first3 = J. | last4 = Mangin | first4 = P. | last5 = Cormier | first5 = L. | title = Robot-assisted or pure laparoscopic nerve-sparing radical prostatectomy: What is the optimal procedure for the surgical margins? A single center experience. | journal = Int J Urol | volume =  | issue =  | pages =  | month = Jul | year = 2012 | doi = 10.1111/j.1442-2042.2012.03102.x | PMID = 22860572 }}</ref>
Note:
*There is likely a strong dependence on stage and grade of cancer, i.e. surgeons that operate more on high grade cancers will probably have a higher margin positive rates.


The impact of positive margins:
The impact of positive margins:
*Significant modest negative affect on long-term outcome in node negative cancers (pT2-4 pN0).<ref name=pmid22901983>{{Cite journal  | last1 = Mauermann | first1 = J. | last2 = Fradet | first2 = V. | last3 = Lacombe | first3 = L. | last4 = Dujardin | first4 = T. | last5 = Tiguert | first5 = R. | last6 = Tetu | first6 = B. | last7 = Fradet | first7 = Y. | title = The Impact of Solitary and Multiple Positive Surgical Margins on Hard Clinical End Points in 1712 Adjuvant Treatment-Naive pT2-4 N0 Radical Prostatectomy Patients. | journal = Eur Urol | volume =  | issue =  | pages =  | month = Aug | year = 2012 | doi = 10.1016/j.eururo.2012.08.002 | PMID = 22901983 }}</ref>
*Significant modest negative affect on long-term outcome in node negative cancers (pT2-4 pN0).<ref name=pmid22901983>{{Cite journal  | last1 = Mauermann | first1 = J. | last2 = Fradet | first2 = V. | last3 = Lacombe | first3 = L. | last4 = Dujardin | first4 = T. | last5 = Tiguert | first5 = R. | last6 = Tetu | first6 = B. | last7 = Fradet | first7 = Y. | title = The Impact of Solitary and Multiple Positive Surgical Margins on Hard Clinical End Points in 1712 Adjuvant Treatment-Naive pT2-4 N0 Radical Prostatectomy Patients. | journal = Eur Urol | volume =  | issue =  | pages =  | month = Aug | year = 2012 | doi = 10.1016/j.eururo.2012.08.002 | PMID = 22901983 }}</ref>
*Weaker impact than stage and Gleason score.<ref>{{Cite journal  | last1 = Chalfin | first1 = HJ. | last2 = Dinizo | first2 = M. | last3 = Trock | first3 = BJ. | last4 = Feng | first4 = Z. | last5 = Partin | first5 = AW. | last6 = Walsh | first6 = PC. | last7 = Humphreys | first7 = E. | last8 = Han | first8 = M. | title = Impact of surgical margin status on prostate-cancer-specific mortality. | journal = BJU Int | volume =  | issue =  | pages =  | month = Jul | year = 2012 | doi = 10.1111/j.1464-410X.2012.11371.x | PMID = 22788795 }}</ref>


====Extraprostatic extension====
====Extraprostatic extension====
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