{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T23:56:05Z","timestamp":1790380565082,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T00:00:00Z","timestamp":1745452800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T00:00:00Z","timestamp":1745452800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the impact of a positive surgical margin (PSM) in relation to the risk of biochemical recurrence (BCR) and additional treatment in different preoperative Cancer of the Prostate Risk Assessment (CAPRA) risk groups after robot\u2010assisted radical prostatectomy (RARP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>Retrospective cohort study of 1039 patients subjected to RARP for prostate cancer at a single European institution. PSM was stratified by extent (focal extensive). The CAPRA score was used for risk group stratification. BCR was defined as a prostate\u2010specific antigen level &gt;0.2\u2009ng\/mL. Additional treatment was defined as salvage radiotherapy (sRT) and\/or androgen\u2010deprivation therapy (ADT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total 227 patients had a PSM (21.8%). When compared to a negative surgical margin, an extensive PSM was associated with an increased risk of BCR (hazard ratio [HR] 2.16, 95% confidence interval [CI] 2.09\u20138.29; HR 3.76, 95% CI 2.33\u20136.06; HR 2.35, 95% CI 1.03\u20135.38) and sRT (HR 3.75, 95% CI 1.45\u20139.7; HR 4.57, 95% CI 2.47\u20138.43; HR 9.32, 95% CI 1.06\u201314.82) in the low\u2010, intermediate\u2010 and high\u2010risk groups, respectively. In high\u2010risk patients a focal PSM was associated with an increased risk of BCR (HR 5.79, 95% CI 1.62\u201320.65), sRT (HR 9.32, 95% CI 1.7\u201350.95) and ADT (HR 4.11, 95% CI 1.08\u201315.57) whereas in low\u2010 and intermediate\u2010risk patients a modest effect on BCR but no significant effect on sRT or ADT was found. We found no significant interaction between CAPRA risk group and PSM (\n                      <jats:italic>P\u2009=<\/jats:italic>\n                      \u20090.25).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>While an extensive PSM was associated with an increased risk of recurrence in all risk groups, a focal PSM was associated with additional treatment only among men with high\u2010risk tumours.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.16732","type":"journal-article","created":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T00:15:01Z","timestamp":1745540101000},"page":"135-142","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Positive surgical margin and oncological outcomes after robot\u2010assisted radical prostatectomy in different Cancer of the Prostate Risk Assessment risk groups"],"prefix":"10.1111","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6755-2112","authenticated-orcid":false,"given":"Anna","family":"Hagman","sequence":"first","affiliation":[{"name":"Department of Molecular Medicine and Surgery Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Pelvic Cancer Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Lantz","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Pelvic Cancer Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Grannas","sequence":"additional","affiliation":[{"name":"Unit of Biostatistics, Institute of Environmental Medicine Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8489-5029","authenticated-orcid":false,"given":"Stefan","family":"Carlsson","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Pelvic Cancer Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olof","family":"Akre","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Pelvic Cancer Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mats","family":"Olsson","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Pelvic Cancer Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8531-222X","authenticated-orcid":false,"given":"Lars","family":"Egevad","sequence":"additional","affiliation":[{"name":"Department of Oncology\u2010Pathology Karolinska Institute  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"H\u00f6ijer","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Wiklund","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery Karolinska Institutet  Stockholm Sweden"},{"name":"Icahn School of Medicine at Mount Sinai Health System  New York City NY 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