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Prognostic impact of lymphovascular invasion in radical prostatectomy specimens
Author(s) -
May Matthias,
Kaufmann Olaf,
Hammermann Fränze,
Loy Volker,
Siegsmund Michael
Publication year - 2007
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2006.06650.x
Subject(s) - lymphovascular invasion , prostatectomy , medicine , nomogram , urology , prostate cancer , pathological , stage (stratigraphy) , oncology , proportional hazards model , cancer , metastasis , biology , paleontology
OBJECTIVE To estimate the prognostic value of lymphovascular invasion (LVI) in patients with node‐negative prostate cancer treated by radical prostatectomy (RP). PATIENTS AND METHODS In all, 412 patients with prostatic adenocarcinoma who had RP and pN0 status were analysed for all established standard pathological factors and LVI. The influence of these pathological findings on biochemical failure was evaluated by multivariate analysis with the Cox model. The mean (range) follow‐up was 52.5 (10–116) months. RESULTS LVI was identified in 42 patients (10.2%) and significantly associated with a high preoperative prostate‐specific antigen (PSA) level, a high PSA density, high percentage of positive biopsy cores, high Gleason score, and seminal vesicle invasion. Of the 42 patients with LVI, 33 (79%) had a Gleason score of ≥ 7 and 27 (64%) had pathological stage pT3. The 5‐year biochemical‐free survival was 87.3% for patients with no LVI and 38.3% with LVI on the RP specimen ( P < 0.001). By multivariate analysis, LVI and Gleason score were independent predictors of biochemical failure. CONCLUSION These results show that in addition to the Gleason score, only LVI is strongly correlated with biochemical failure after RP. These findings support the routine evaluation of LVI status in RP specimens and provide the option for its incorporation into nomograms predictive of oncological outcome.