LYMPHOVASCULAR INVASION IS AN INDEPENDENT PROGNOSTIC FACTOR IN PROSTATIC ADENOCARCINOMA

No AccessJournal of UrologyAdult Urology: Oncology: Prostate/Testis/Penis/Urethra1 Dec 2005LYMPHOVASCULAR INVASION IS AN INDEPENDENT PROGNOSTIC FACTOR IN PROSTATIC ADENOCARCINOMA LIANG CHENG, TIMOTHY D. JONES, HAIQUN LIN, JOHN N. EBLE, GORDON ZENG, MATTHEW D. CARR, and MICHAEL O. KOCH LIANG CHENGLIANG CHENG More articles by this author , TIMOTHY D. JONESTIMOTHY D. JONES More articles by this author , HAIQUN LINHAIQUN LIN More articles by this author , JOHN N. EBLEJOHN N. EBLE More articles by this author , GORDON ZENGGORDON ZENG More articles by this author , MATTHEW D. CARRMATTHEW D. CARR More articles by this author , and MICHAEL O. KOCHMICHAEL O. KOCH More articles by this author View All Author Informationhttps://doi.org/10.1097/01.ju.0000181215.41607.c3AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Gleason grade and tumor stage are well established prognostic factors in prostate cancer. Histological demonstration of tumor in lymphovascular spaces has been associated with poor prognosis in many tumor types but it is not included in current prostate cancer grading and staging schemes. Whether lymphovascular invasion is an independent prognostic factor for disease progression in prostate cancer is uncertain. We retrospectively investigated lymphovascular invasion as a predictive factor for biochemical failure and cancer specific survival following radical prostatectomy. Materials and Methods: The records of 504 patients with prostatic adenocarcinoma undergoing radical prostatectomy were reviewed for lymphovascular invasion. Clinical followup data were available on 459 cases. Mean followup was 44 months (range 1.5 to 144). Multivariate analysis was performed using the Cox model. Results: Lymphovascular invasion was identified in 106 cases (21%). Univariate analysis showed a significant association between lymphovascular invasion and higher preoperative serum prostate specific antigen (PSA), advanced pathological stage, higher Gleason score, positive surgical margins, extraprostatic extension, seminal vesicle invasion, lymph node metastasis and perineural invasion (each p <0.001). No association was observed between lymphovascular invasion and patient age at surgery, prostate weight or high grade prostatic intraepithelial neoplasia. Lymphovascular invasion was an independent predictor of PSA recurrence (HR 1.6, 95% CI 1.12 to 2.38, p = 0.01) and cancer specific survival (HR 2.75, 95% CI 1.04 to 2.28, p = 0.041) after controlling for tumor stage, surgical margins and Gleason grade on multivariate analysis. Five-year cancer specific survival was 90% in men with lymphovascular invasion compared to 98% in those without lymphovascular invasion (p <0.001). Conclusions: Lymphovascular invasion can be identified in approximately 20% of prostate cancer cases. Lymphovascular invasion is an independent risk factor for PSA recurrence and cancer death in patients with prostate cancer. References 1 : Incidence and prognostic significance of lymphatic and vascular invasion in radical prostatectomy specimens. Prostate1989; 15: 149. Google Scholar 2 : Microvascular invasion in prostate cancer correlates with pathologic stage. Arch Pathol Lab Med1995; 119: 1050. Google Scholar 3 : Significance of demonstrable vascular space invasion for the progression of prostatic adenocarcinoma. Am J Surg Pathol1996; 20: 1351. Google Scholar 4 : Tumour control according to pathological variables in patients treated by radical prostatectomy for clinically localized carcinoma of the prostate. Br J Urol1997; 79: 203. 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Google Scholar From the Departments of Pathology and Laboratory Medicine (LC, TDJ, JNE, GZ, MDC) and Urology (LC, MOK), Indiana University School of Medicine, Indianapolis, Indiana and Department of Biostatistics, Yale University (HL), New Haven, Connecticut© 2005 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byYu J, Makarov D, Sharma R, Peschel R, Partin A and Gross C (2018) Validation of the Partin Nomogram for Prostate Cancer in a National SampleJournal of Urology, VOL. 183, NO. 1, (105-111), Online publication date: 1-Jan-2010. Volume 174Issue 6December 2005Page: 2181-2185 Advertisement Copyright & Permissions© 2005 by American Urological Association, Inc.Keywordsneoplasm invasivenessprostateprostatic neoplasmsprostatectomydisease progressionMetricsAuthor Information LIANG CHENG More articles by this author TIMOTHY D. JONES More articles by this author HAIQUN LIN More articles by this author JOHN N. EBLE More articles by this author GORDON ZENG More articles by this author MATTHEW D. CARR More articles by this author MICHAEL O. KOCH More articles by this author Expand All Advertisement PDF downloadLoading ...