{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T21:46:47Z","timestamp":1766180807454,"version":"build-2065373602"},"reference-count":28,"publisher":"Wiley","issue":"S3","license":[{"start":{"date-parts":[[2015,7,27]],"date-time":"2015-07-27T00:00:00Z","timestamp":1437955200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"The Royal College of Pathologists of Australia"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2015,10]]},"abstract":"\n Objective<\/jats:title>\n \n To assess the influence of tumour zonality on biochemical recurrence (\n BCR<\/jats:styled-content>\n ) after radical prostatectomy (\n RP<\/jats:styled-content>\n ) with a histologically confirmed positive surgical margin (\n PSM<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Patients and Methods<\/jats:title>\n \n Data from 382 patients that underwent\n RP<\/jats:styled-content>\n with either transition zone (\n TZ<\/jats:styled-content>\n ) or peripheral zone (\n PZ<\/jats:styled-content>\n ) tumours involving\n PSMs<\/jats:styled-content>\n between 1998 and 2010 were retrieved from the\n A<\/jats:styled-content>\n bbott\n W<\/jats:styled-content>\n est\n A<\/jats:styled-content>\n ustralian\n P<\/jats:styled-content>\n rostatectomy\n D<\/jats:styled-content>\n atabase. Statistical analysis was used to evaluate the relationship of various tumour clinicopathological parameters, e.g. zonal origin of tumour, tumour volume,\n G<\/jats:styled-content>\n leason score, and stage to the development of\n BCR<\/jats:styled-content>\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n There were 51\n TZ<\/jats:styled-content>\n and 331\n PZ<\/jats:styled-content>\n tumours with\n PSMs<\/jats:styled-content>\n identified. The\n TZ<\/jats:styled-content>\n tumours compared with\n PZ<\/jats:styled-content>\n tumours were larger (median 5.67 vs 3.64\u2009mL,\n P<\/jats:italic>\n < 0.001), more frequently lower grade (\n G<\/jats:styled-content>\n leason score 6 33% vs 5%,\n P<\/jats:italic>\n < 0.01), organ confined (51% vs 35.6%,\n P<\/jats:italic>\n = 0.073), and preferentially involved the bladder neck (49% vs 6%,\n P<\/jats:italic>\n < 0.001). Tumour zonality was not associated with\n BCR<\/jats:styled-content>\n for the entire cohort.\n TZ<\/jats:styled-content>\n and\n PZ<\/jats:styled-content>\n tumours had similar 5\u2010year\n BCR<\/jats:styled-content>\n \u2010free survival rates (58% vs 63%,\n P<\/jats:italic>\n = 0.691) and comparable time to development of\n BCR<\/jats:styled-content>\n (14.4 vs 19.2 months,\n P<\/jats:italic>\n = 0.346). On univariate analysis, preoperative\n PSA<\/jats:styled-content>\n level,\n PSM<\/jats:styled-content>\n at the bladder neck, tumour volume,\n G<\/jats:styled-content>\n leason score (\n P<\/jats:italic>\n < 0.001) and tumour stage were independent predictors of\n BCR<\/jats:styled-content>\n for the entire cohort. On multivariate analysis tumour volume and\n G<\/jats:styled-content>\n leason score retained significance as independent predictors of\n BCR<\/jats:styled-content>\n . Tumour zonality was not directly associated with\n BCR<\/jats:styled-content>\n . Of the patients who received adjuvant therapy, the incidence of\n BCR<\/jats:styled-content>\n was similar for\n TZ<\/jats:styled-content>\n and\n PZ<\/jats:styled-content>\n tumours (58% vs 67%,\n P<\/jats:italic>\n = 0.077), although\n TZ<\/jats:styled-content>\n tumours failed significantly earlier (mean 4.4 vs 16.4 months,\n P<\/jats:italic>\n = 0.037).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n PSA<\/jats:styled-content>\n recurrence in patients with histologically confirmed\n PSMs<\/jats:styled-content>\n after\n RP<\/jats:styled-content>\n is independent of the zonal location of the index tumour. However, tumour zonal origin may have an indirect influence on\n PSA<\/jats:styled-content>\n relapse, as\n TZ<\/jats:styled-content>\n tumours tend to be of large volume and more likely involve the bladder neck margin, both risk factors for\n BCR<\/jats:styled-content>\n . Bladder neck margin involvement is associated with higher rates of\n BCR<\/jats:styled-content>\n than other sites of\n PSMs<\/jats:styled-content>\n . The preoperative identification of\n TZ<\/jats:styled-content>\n tumours might aid surgical planning with appropriate alteration of\n RP<\/jats:styled-content>\n technique to incorporate wider surgical margins at the bladder neck. Adjuvant radiotherapy appears to be associated with adverse outcome for\n TZ<\/jats:styled-content>\n tumours, a novel finding which warrants further investigation.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bju.13173","type":"journal-article","created":{"date-parts":[[2015,7,27]],"date-time":"2015-07-27T06:12:57Z","timestamp":1437977577000},"page":"42-48","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Prostate carcinoma with positive margins at radical prostatectomy: role of tumour zonal origin in biochemical recurrence"],"prefix":"10.1111","volume":"116","author":[{"given":"Luke M.","family":"O'Neil","sequence":"first","affiliation":[{"name":"School of Medicine University of Notre Dame Fremantle Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shane","family":"Walsh","sequence":"additional","affiliation":[{"name":"Uropath Pty Ltd Perth Western Australia Australia"},{"name":"West Australian Urologic Research Organisation Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald J.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Uropath Pty Ltd Perth Western Australia Australia"},{"name":"School of Pathology and Laboratory Medicine Faculty of Medicine and Dentistry University of Western Australia Perth Western Australia Australia"},{"name":"West Australian Urologic Research Organisation Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Lee","sequence":"additional","affiliation":[{"name":"Uropath Pty Ltd Perth Western Australia Australia"},{"name":"School of Pathology and Laboratory Medicine Faculty of Medicine and Dentistry University of Western Australia Perth Western Australia 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