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Master Thesis

Marges chirurgicales positives et progression biologique après prostatectomie totale pour tumeur de stade pT2

Abstract : Introduction: recommendations are unclear about the management of patients operated for pT2 prostate cancer (PC) with positive surgical margins (PSM). The primary objective of this study was to evaluate the impact of PSM on biological recurrence (BR) and to determine the factors associated with BR in case of PSM. The secondary objective was to study BR after salvage radiotherapy (SRT) in case of PSM. Method: analysis of 2429 patients operated for pT2 PC between 1988 and 2018 was performed. No patient received adjuvant or neoadjuvant therapy. RB was defined by two consecutive PSA> 0.2ng / ml. Biochemical reccurence-free survival (BRFS) was calculated using Kaplan-Meier method. Univariate analyzes were used to determine factors associated with BR. Results: MCP rate was 17.3%, median follow-up was 116 months. BRFS at 3, 5, and 10 years was 83.3%, 79.4%, and 66.6% in case of PSM, respectively. It was 96%, 92.3% and 84% at 3,5 and 10 years in the negative margins group (p> 0.0001). Parameters associated with RB were PSA level, Gleason score of preoperative biopsies, and length of MCP. Of the 53 patients treated with SRT, 9 (16.98%) presented a new RB. Conclusion: MCP in pT2 CP is associated with poor prognosis in terms of BR. Only a small number of pT2R1 cancer will present biological recurrence. The use of systematic adjuvant radiotherapy in these patients therefore represents a risk of overtreatment, with the risk of adverse effects inherent to irradiation and does not seem recommended.
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Master Thesis
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Submitted on : Friday, September 27, 2019 - 3:35:54 PM
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  • HAL Id : dumas-02299198, version 1


Elena Saier. Marges chirurgicales positives et progression biologique après prostatectomie totale pour tumeur de stade pT2. Médecine humaine et pathologie. 2018. ⟨dumas-02299198⟩



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