Is the apical margin real? An analysis of postprostatectomy PSA failure by site of involved margin.

105 Background: Though an involved margin at prostatectomy has been associated with elevated rates of PSA relapse, there has been an absence of consensus regarding the risk of relapse specific to the site(s) of margin involvement. Specifically, the apical margin has been sometimes considered "lower risk," based upon historical series. The present study seeks to determine the rate of PSA relapse in patients who had undergone prostatectomy with involved surgical margin, without immediate post-operative (adjuvant) therapy, with comparison of relapse rates by site of involved margin. Methods: A retrospective database review was performed, including patients with clinically localized prostate cancer and pre-operative PSA <30, who had undergone prostatectomy, with site(s) of involved margin characterized. Slides were re-reviewed by a pathologist for verification of site of margin involvement. Patients were excluded if seminal vesicle invasion or lymph node involvement was noted in the surgical specimen, if any ...