[Assessment of positive surgical margins in the management of patients after radical prostatectomy for pT2 prostate cancer]. / Impact des marges chirurgicales positives après prostatectomie radicale chez les patients atteints d'un cancer de la prostate localisé pT2.

INTRODUCTION: Few data are available regarding positive surgical margins (PSM) in patients who underwent surgery for localized prostate cancer (PC). Our objective was to evaluate the impact of PSM on biochemical recurrence-free survival (BRFS) for patients who underwent PC for pT2 tumor without adjuvant treatment. METHODS: We included each patient who underwent radical prostatectomy for pT2N0 PC between 1988 and 2018. Primary endpoint was biochemical recurrence (BR). BRFS was calculated using Kaplan-Meier method. Univariate and multivariate analyses were used to determine factors associated with BR and PSM. RESULTS: Overall, 2429 patients were included whom 420 patients had PSM (17.3%). Median follow-up was 116 months. BRFS at 10 years was 66.6% in case of PSM, and 84% in the negative margins group (P<0.0001). Parameters associated with BR were preoperative PSA level (P<0.0001), Gleason score (P<0.0001), tumor volume in biopsies, and margins length (P<0.04). CONCLUSION: PSM in pT2N0 CP are associated with poor prognosis in terms of BR. Nevertheless, only a small number of pT2R1 cancer will present biological recurrence. The use of adjuvant radiotherapy in these patients therefore represents a risk of overtreatment, with the risk of adverse effects inherent to irradiation. Clinical and biological monitoring in case of PSM seems acceptable.

The ratio of free to esterified cholesterol in serum. A new discriminant in correlating lipid metabolism with disease state.

A normal range has been established for the ratio of free to esterified cholesterol in serum. It has been observed that whereas this ratio remains constant in clinically healthy subjects and is not influenced by sex or age, it is markedly altered in certain disease states. The present study is concerned with the correlation of the normal free:esterified cholesterol ratio with ratios determined for 148 patients hospitalized for various reasons. This study has allowed correlations to be made with respect to various groups of diseases, such as cardiac disease and cancer. Changes in the free:esterified cholesterol ratios offer a new and incisive discriminant in correlating the relationships between cholesterol and various diseases. The methods used were gas-liquid chromatography for determination of "free" and "total" cholesterol and the new enzymatic methods for "free" and "total" cholesterol.