Positive margin patients

This is the term used to describe any evidence of cancer cells at the edge of the removed prostate tissue. This would present a possible risk of some tumour cells remaining in the surgical field and therefore a threat of the cancer returning.

In a traditional radical prostatectomy, a significant amount of the nerves and tissues adjacent to the prostate are removed and the risk of positive margins has tended to be lower. A nerve-sparing procedure demands greater technical skill to preserve the adjacent nerves but ensure all malignant cells are removed.

This relative risk is balanced by a judgement made before surgery about whether an individual patient is suitable for nerve-sparing surgery, based on their grading, staging and PSA.

The index study enables Mr Doherty to record and assess positive and negative margins. Where there is a positive margin, the post-operative PSA result is a particularly important measure. If there is a positive margin, but PSA reading remains at 0.01 or less, this is thought to be a clear indication that a positive margin has not caused any added risk.

Positive and negative margin cases among index patients

Positive and negative margins among the index group of patients (Group: 47 patients).