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Postive margins after surgery ...


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Old 10-12-2018, 05:19 AM   #1
millironk
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Postive margins after surgery ...

Had robotic surgery that went well...pathology report states limited location Positive margin greater than.....any comments on positive margins would be appreciated. thanks

 
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Old 10-15-2018, 04:40 AM   #2
IADT3since2000
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Re: Postive margins after surgery ...

Hi millironk,

Many men with positive margins after surgery do very well, though it is a higher risk factor for recurrence and warrants diligent monitoring; one expert suggests monitoring PSA monthly for a while, once it has had time to settle down after the surgery.

While we laymen tend to think that cells outside the prostate after surgery are bound to cause a recurrence, it often does not happen. Maybe the surgical removal kind of pulled all the nearby cancer cells at the margin out too so that nothing remains even though the margin was positive. Maybe there were cells remaining beyond the prostate after surgery but they simply were not capable of sustaining themselves on their own. Perhaps the surgical removal of the prostate and capsule cut off their blood supply and they died.

There has been a lot of published medical research on this, which you can access for free. Go to PubMed (Public Medicine) at www.pubmed.gov, a US government web site, and search for something like - (prostate cancer OR radical prostatectomy) AND positive margin . I just did that and got 1,756 hits, each representing a published paper. You can see brief discussions ("abstracts") of each paper by clicking on the blue hypertext. Some give you links to free copies of the complete paper. If you click on the filter on the left for "Abstract", it reduces the number to 1,731 (a few papers don't have abstracts). If you filter for Show additional filters, then Search Fields, then Show, then Choose, then drop down and select Title, and finally click Apply (easier to do than say), you will reduce the list to just those papers that have the elements in your search in the title of the paper. Doing this increases the relevance and reduces this list to 110. Paper number 4 in the list (as of today), a very recent July 2018 Chinese paper by Zhang and team, looked at results from many studies covering 37,928 patients. A copy of the complete paper is available via www.pubmed.gov. One value of this paper is that it gives the list of references for the studies it looked at, and tables in the paper describe key characteristics of each study. That can help you check circumstances closer to yours. Reference 26, which you can access directly at https://www.ncbi.nlm.nih.gov/pubmed/19913824, indicates odds of recurrence depending on your risk group. I can help interpret what you find in these studies if you need help.

Good luck!

Last edited by IADT3since2000; 10-15-2018 at 04:44 AM. Reason: Added sentences near the beginning and at the end right after posting.

 
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