SAN DIEGO, CA USA (UroToday.com) - Seminal vesicle invasion (SVI) and positive lymph node involvement (LNI) are well-described adverse pathologic features that portend poor outcomes following radical prostatectomy (RP).
In this study, the authors investigated the comparative impact of LNI on survival following RP for patients with and without concurrent seminal vesicle invasion.
Researchers from the Mayo Clinic identified 15 833 patients who underwent RP without neoadjuvant therapy from 1987-2009 and stratified patients according to the presence (n = 1,597) or absence (n = 14,236) of SVI, as well as according to the presence (n =667) or absence (n = 15,166) of LNI. With a median follow-up after RP of 9.5 years, 470 patients died of prostate cancer. Four-hundred twenty-two patients (27%) had both SVI and LNI on final pathology. Fifteen-year cancer-specific survival was 97% (- SVI or - LNI), 88% (+ LNI, -SVI) and 84% (+SVI, - LNI or SVI-, LNI+), but were the lowest (77%) in patients who were both SVI+LNI+. The authors found LNI was significantly associated with death from prostate cancer regardless of SVI status. However, this association was more than 2-fold greater among patients without SVI than among patients with SVI (only 50%greater) on multivariate analysis.
The authors conclude SVI and LNI appear to have a similar impact on prostate cancer-specific survival in patients undergoing RP. However, in patients with locally advanced tumor stage, the impact of LNI as a prognostic feature was diminished significantly. Based on these results, the authors reinforce the importance of achieving maximal local tumor control during RP for high-risk prostate cancer, regardless of LNI.
Abstract Title: Comparative impact of seminal vesical invasion versus lymph node metastases on survival for patients following radical prostatectomy
Presented by Manuel S. Eisenberg, R. Jeffrey Karnes, Dharam Kaushik, Laureano Rangel, Eric Bergstralh, and Stephen A. Boorjian at the American Urological Association (AUA) Annual Meeting - May 4 - 8, 2013 - San Diego Convention Center - San Diego, California USA
Reported for UroToday.com by Anthony T. Corcoran, MD
