Eur Urol Suppl 2011;10(2):284 BCR: PSA value ≥0.2µg/L (Early if BCR occurred in ≤12 months and late BCR if occurred after 12 months). results: There were 424 patients who had RP and 107 (25.3%) had PSM. Lymph nodes (LN) were positive in 3(2.8%). Treatment failure occurred in 13 (12.5%) with majority having pT3 disease. There were 91 patients who fulflled the study criteria and median PSA, age and follow-up were 9µg/L, 63 years and 36 months, respectively. There were 41(45%) with FPSM and 50 (55%) with EPSM. Median time to BCR was 24 months in FPSM Vs 12 months in EPSM. BCR occurred in 8(19.6%) in FPSM Vs 21(42%) in EPSM. Incidence of BCR was higher in both groups with pT3 disease (FPSM 5(31.3%) and EPSM 14(44%)). During the mean study period of 48.3 months BCR free survival was 80.4% and 58% in FPSM & EPSM, respectively. Radiotherapy treatment for BCR had success rate of 100% and 94% in FPSM and EPSM groups, respectively. Conclusions: Watchful wait is a reasonable option for patients with FPSM particularly those with organ confned disease. Immediate adjuvant radiotherapy can be reserved for patients with EPSM and pT3 disease. 903 does surgiCal Margin status PrediCt reCurrenCe after laParosCoPiC radiCal ProstateCtoMy? exPerienCe after 400 ProCedures Porpiglia F., Fiori C., Manfredi M., Grande S., Lucci Chiarissi M., Morra I., Ragni F., Scarpa R.M. ´San Luigi Gonzaga´ Hospital, University of Turin, Dept. of Urology, Orbassano, Italy introduction & objectives: The aim of this study was to analyze the surgical margins status of prostatic glands, resected by laparoscopic radical prostatectomy (RP) for prostate cancer, and to correlate it with biochemical free survival rate (BFSR). Materials & Methods: The population was selected from the database of 405 patients underwent RP from 7/2000 to 12/2009 at our Department. To isolate the effect of surgical margins on BFSR, were excluded from the study the patients undergoing neoadjuvant or adjuvant therapy. 300 patients matched all the criteria, 232 of these (77.3%) had negative surgical margins (NSM) and 68 (22.7%) positive surgical margins (PSM). The median follow-up was 56 (7-118) months. We investigated the prognostic value of PSM regarding the BFSR and regarding the tumour-specifc and non specifc mortality. Biochemical recurrence was defned as increase in PSA values above the threshold of 0.2 ng/ml. PSM were then classifed: by extension, in <= 3 mm (77.8%) and > 3 mm (38.9%); by location, in apical (44.1%) and not apical (55.9%); by number in monofocal (77.9%) and multifocal (22.1%). These data were then entered into a multivariate analysis to assess the weight of each independent prognostic factor for biochemical recurrence, along with age, preoperative PSA, pathologic Gleason Score, pT stage, prostate and tumour volume. results: The BFSR rate was 67.6% for PSM and 88.8% for NSM. A statistical signifcant difference between the two groups was identifed by univariate survival analysis (p < 0.001) and multivariate analysis (hazard ratio or HR 3.78, 95% CI 1.91-7.51, p 0.0001). Patients with PSM also showed a worse tumour-specifc and nonspecifc survival compared with NSM, but this was not statistically signifcant. According to the extension, BFSR was 77.8% in < 3 mm PSM and 38.9% in > 3 mm PSM (p = 0.003 - univariate survival analysis). In multivariate analysis, the HR of 5.46 (95% CI 1.42-21.07, p 0.013) indicates that a PSM > 3 mm is the most important risk factor for biochemical recurrence in our series, comparing it with pT (HR 4.54, 95% CI 1.02-20.16, p 0.047) and PSA (HR 3.82, 95% CI 1.11- 13.16, p 0.033). As for the PSM location, in our study an apical margin has been demonstrated at greater risk of biochemical recurrence in the univariate analysis. BFSR was 59% in apical PSM and 77% in not apical PSM (p = 0.038). This risk lost statistical signifcance in multivariate analysis (p = 0.06). Regarding the number, the increased risk due to multifocality, demonstrated by the univariate analysis (BFSR was 73% in monofocal PSM and 53% in multifocal PSM, p = 0.014), was not confrmed in multivariate analysis (p = 0.38). Conclusions: We recommend careful evaluation of patients with positive surgical margins with regard to possible adjuvant therapy after radical surgery. The suggestion is stronger if the margin is more than 3 mm, regardless of its location and multifocality. 904 does the teChniQue of bladder neCk disseCtion during oPen radiCal retroPubiC ProstateCtoMy affeCt the rate of Positive surgiCal Margin? Spanopoulos S., Stathouros G., Megas G., Savvaidis S., Ntoumas K., Fragoulis A. General Hospital of Athens "G Gennimatas", Dept. of Urology, Athens, Greece introduction & objectives: The bladder neck dissection during open radical retropubic prostatectomy is of utmost importance, since it refects the need to respect the anatomic and functional integrity of the proximal sphincteric unit affecting the overall continence state after surgery. The primary goal however must be the safe oncologic result, in terms of a negative surgical margin status. In the present study we compare two methods of bladder neck dissection and their oncologic results. Materials & Methods: In a three years period, from January 2005 to December 2007, we operated on 148 patients (group A) performing the standard bladder neck dissection followed by the "racket type" bladder neck reconstruction. Another 164 patients (group B) were operated in the following 2 year period, from January 2008 to December 2009, performing a careful anatomic dissection preserving the bladder neck. We retrospectively compared the positive surgical margin rate of the two groups. Biochemical failure was defned as a PSA rise >0.2 ng/ml in two subsequent measures. Continence was defned as no need to use pads or diapers. results: There was no signifcant difference in age, PSA and prostatic size preoperatively in both groups. Operative time, mean blood loss and transfusion rate were similar. In group A the overall positive surgical margin rate was 18.9% while in group B the overall positive surgical margin rate was 20.1%. When controlling for specifc bladder neck positive surgical margin localization, the rate was low in both groups, 4.05% and 3.05% respectively. However, a statistically signifcant lower incontinence rate was found in group B (1.2% in group B versus 5.4% in group A, p 0.05). Mean catheterization time was similar. No difference was found regarding the biochemical failure rate. Conclusions: The bladder neck participates actively in the post-prostatectomy continence. The preservation of the bladder neck during dissection in radical prostatectomy is oncologically safe and should be routinely undertaken. 905 iMPaCt of Positive surgiCal Margins on Psa failure after radiCal ProstateCtoMy in adjuvant treatMent-naïve Patients Ploussard G., Agamy M.A., Alenda O., Allory Y., Mouracade P., Vordos D., Hoznek A., Abbou C.C., De La Taille A., Salomon L. INSERM U955, Team 7, Dept. of Urology, CHU Mondor, Creteil, France introduction & objectives: We aimed to study the impact of PSM as an independent predictor of PSA failure after RP in adjuvant treatment-naïve patients. Materials & Methods: From 2000 to 2008, 1943 men who underwent a RP at Henri Mondor Hospital and who did not receive neoadjuvant or adjuvant therapy were included. Follow-up was recorded into a prospective database. Mean follow- up was 68.8 months. We evaluated the biochemical recurrence-free survival (RFS), defned by a PSA >0.2 ng/ml, and the need for salvage therapy in univariate and multivariate models. results: PSA failure was reported in 14.7% and PSM were noted in 25.6%. In the overall cohort, PSM was signifcantly predictive for PSA failure (p<0.001; HR 2.6), need for salvage therapy (p<0.001; HR 2.9), and specifc deaths (p=0.006; HR 3.7). The 5-year RFS was 84.4% in men with negative margins, compared with 57.5% in case of PSM. After stratifcation by pathologic stage and Gleason score, margin status was signifcantly predictive for PSA failure in pT2 (p<0.001), pT3a (p=0.001), and/ or Gleason score≤7 cancers (p<0.001), whereas the impact of PSM did not reach signifcance in pT3b (p=0.196), pT4 (p=0.061) and/or Gleason score≥8 cancers (p=0.115) Conclusions: Positive surgical margin is associated with a poor prognosis in terms of RFS and need for salvage therapy. Such a distinction between negative or positive margin cancers seems to appear clinically less relevant in locally advanced disease with seminal vesicle or high Gleason score≥8. 906 even solitary aPiCal Positive surgiCal Margins ≤3 mm comPromise oncoLogicaL oUTcome following radiCal ProstateCtoMy: an analysis of More than 1000 Patients based on whole Mount seCtions Burger M. 1 , Brookman-May S. 1 , Weißbach L. 2 , Herbst H. 3 , Gilfrich C. 4 , Papadopoulos T. 5 , Roigas J. 6 , Hofstädter F. 7 , Wieland W.F. 1 1 Caritas St. Josef Medical Centre, University of Regensburg, Dept. of Urology, Regensburg, Germany, 2 Foundation of Men's Health, Dept. of Urology, Berlin, Germany, 3 Region South/West Vivantes GmbH, Dept. of Pathology, Berlin, Germany, 4 Clinic St. Elisabeth, Dept. of Urology, Straubing, Germany, 5 Region North/East Vivantes GmbH, Dept. of Pathology, Berlin, Germany, 6 Vivantes Clinic in Friedrichshain und Vivantes Clinic am Urban, Dept. of Urology, Berlin, Germany, 7 University of Regensburg, Dept. of Pathology, Regensburg, Germany introduction & objectives: Recently the extent of positive surgical margins have been debated as decisive for oncological outcome and adjuvant measurements have been suggested for pronounced margins only. However available data are conficting and respective decision making remains brittle. To evaluate the prognostic impact of positive surgical margins in radical prostatectomy specimens in dependency on multifocality, localization, and extent. Materials & Methods: 1036 patients staged pT2-3a,pN0,M0 were followed up for a mean 60 months. No patient was subject to adjuvant or neoadjuvant therapy. All specimens were routinely processed by complete whole mount sectioning. Standard pathological parameters and exact number, localization, and extent of PSM were reassessed. results: 267 patients (26%) demonstrated positive surgical margins (20% of pT2, 48% of pT3a). Preoperative PSA, Gleason-Score, and positive surgical margins were found to be independent predictors of biochemical failure. Biochemical failure- free survival rates after seven years for patients without and with positive surgical