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Positive surgical margin

User
Posted 05 Sep 2019 at 17:03

I am 52 and was underwent Robotic Prostatectomy.

Unfortunately the biopsy had shown positive surgical margins, but 'organ confined'.

I understand this means I will have to live with the knowledge that there could be recurrence?

My urologist is optimistic, but cannot commit on anything for sure understandably.

Anyone has had similar issue and experience?

Stage: pT2* as per biopsy.

I thought my cancer was caught early, but perhaps my surgeon was trying hard to preserve the nerves?

 

User
Posted 05 Sep 2019 at 17:31

It's not intuitive I know but the statistics show there isn't much difference in recurrence rates between positive and negative margins.

Remember that the surgery trauma (hot knife etc) kills cells beyond the incision so fingers crossed the surgeon has not left any viable cells behind.

Checkout these nomograms they will tell you your risk of a recurrence based on stage Gleason score etc

https://www.mskcc.org/nomograms/prostate

The good news if thee is any with PC is that if you do have a recurrence positive margins improve your chances of sucessful salvage therapy.

 

 

 

 

User
Posted 05 Sep 2019 at 17:34
The pathology often finds that the cancer was either more extensive than first thought, closer to the edge than expected or of a higher grade that the biopsy had indicated. With positive margins, your statistical likelihood of full remission is now lower than it was but some men have positive margins and never need further treatment so don't assume. Much will depend on your first post-op PSA test.

My husband was slightly younger than you at diagnosis and had 2 years before he needed salvage treatment. Seven years on, his PSA still tootles along at 0.1 so the poor pathology wasn't the end of the world at all.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 05 Sep 2019 at 17:46

Thank you so much. I didn't know such tool existed, gives me  general idea now.

User
Posted 05 Sep 2019 at 17:48

Thanks for the reply.

My first PSA is due in 4 weeks and will update

 
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