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Biochemical and pathological predictors of the recurrence of prostatic adenocarcinoma with seminal vesicle invasion.
J Urol. 2003 Jan; 169(1):153-6.JU

Abstract

PURPOSE

We assessed biochemical and pathological factors as predictors of recurrence in men with seminal vesicle invasion.

MATERIALS AND METHODS

A consecutive series of 812 men who underwent radical retropubic prostatectomy between 1992 and 2000 included 106 (13%) with seminal vesicle invasion. Disease recurrence was defined as prostate specific antigen (PSA) 0.4 ng./ml. or greater. Patients with less than 12 months of followup, salvage radical retropubic prostatectomy, lymph node metastases and adjuvant therapy were excluded from study. Data on the remaining 66 cases were analyzed using the chi-square test, bivariate logistic regression, Kaplan-Meier analyses and Cox proportional regression. Variables included demographics, recurrence, time from surgery to recurrence, positive margins, capsular invasion, extracapsular extension, Gleason score (2 to 6, 7 and 8 to 10), and dichotomized values of preoperative PSA (10 or less versus 10 ng./ml.) and tumor volume (20% or less versus greater than 20%).

RESULTS

Mean patient age was 62 years (range 48 to 74). At an average followup of 47.7 months (range 13 to 109) 53% of the patients were free of biochemical recurrence. Mean time to recurrence was 18.6 months (range 1.7 to 51.6). Univariate analyses revealed a statistical significant increased risk of recurrence in patients with PSA greater than 10 ng./ml. (p <0.0001), capsular invasion (p = 0.01) and age (p = 0.036). When adjusting for potential covariates, Cox proportional regression analysis indicated that higher PSA (hazard ratio 7.33, 95% CI 2.57 to 20.95), larger tumor volume (hazard ratio 5.64, 95% CI 1.97 to 16.19) and higher age (hazard ratio 1.13, 95% CI 1.04 to 1.22) were significantly associated with shorter time to recurrence.

CONCLUSIONS

PSA greater than 10 ng./ml., tumor volume greater than 20% and age are significant predictors of recurrence after radical retropubic prostatectomy in patients with prostate cancer and seminal vesicle invasion. Hopefully future randomized trials may show a survival benefit of adjuvant therapy in patients at high risk.

Authors+Show Affiliations

Sofer M
Departments of Urology and Pathology, University of Miami, Miami, Florida, USA.
Savoie M
No affiliation info available
Kim SS
No affiliation info available
Civantos F
No affiliation info available
Soloway MS
No affiliation info available

MeSH

AdenocarcinomaAgedHumansMaleMiddle AgedMultivariate AnalysisNeoplasm InvasivenessNeoplasm Recurrence, LocalProportional Hazards ModelsProstate-Specific AntigenProstatectomyProstatic NeoplasmsRisk FactorsSeminal Vesicles

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12478125

Citation

Sofer, Mario, et al. "Biochemical and Pathological Predictors of the Recurrence of Prostatic Adenocarcinoma With Seminal Vesicle Invasion." The Journal of Urology, vol. 169, no. 1, 2003, pp. 153-6.
Sofer M, Savoie M, Kim SS, et al. Biochemical and pathological predictors of the recurrence of prostatic adenocarcinoma with seminal vesicle invasion. J Urol. 2003;169(1):153-6.
Sofer, M., Savoie, M., Kim, S. S., Civantos, F., & Soloway, M. S. (2003). Biochemical and pathological predictors of the recurrence of prostatic adenocarcinoma with seminal vesicle invasion. The Journal of Urology, 169(1), 153-6.
Sofer M, et al. Biochemical and Pathological Predictors of the Recurrence of Prostatic Adenocarcinoma With Seminal Vesicle Invasion. J Urol. 2003;169(1):153-6. PubMed PMID: 12478125.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Biochemical and pathological predictors of the recurrence of prostatic adenocarcinoma with seminal vesicle invasion. AU - Sofer,Mario, AU - Savoie,Marc, AU - Kim,Sandy S, AU - Civantos,Francisco, AU - Soloway,Mark S, PY - 2002/12/13/pubmed PY - 2003/1/10/medline PY - 2002/12/13/entrez SP - 153 EP - 6 JF - The Journal of urology JO - J Urol VL - 169 IS - 1 N2 - PURPOSE: We assessed biochemical and pathological factors as predictors of recurrence in men with seminal vesicle invasion. MATERIALS AND METHODS: A consecutive series of 812 men who underwent radical retropubic prostatectomy between 1992 and 2000 included 106 (13%) with seminal vesicle invasion. Disease recurrence was defined as prostate specific antigen (PSA) 0.4 ng./ml. or greater. Patients with less than 12 months of followup, salvage radical retropubic prostatectomy, lymph node metastases and adjuvant therapy were excluded from study. Data on the remaining 66 cases were analyzed using the chi-square test, bivariate logistic regression, Kaplan-Meier analyses and Cox proportional regression. Variables included demographics, recurrence, time from surgery to recurrence, positive margins, capsular invasion, extracapsular extension, Gleason score (2 to 6, 7 and 8 to 10), and dichotomized values of preoperative PSA (10 or less versus 10 ng./ml.) and tumor volume (20% or less versus greater than 20%). RESULTS: Mean patient age was 62 years (range 48 to 74). At an average followup of 47.7 months (range 13 to 109) 53% of the patients were free of biochemical recurrence. Mean time to recurrence was 18.6 months (range 1.7 to 51.6). Univariate analyses revealed a statistical significant increased risk of recurrence in patients with PSA greater than 10 ng./ml. (p <0.0001), capsular invasion (p = 0.01) and age (p = 0.036). When adjusting for potential covariates, Cox proportional regression analysis indicated that higher PSA (hazard ratio 7.33, 95% CI 2.57 to 20.95), larger tumor volume (hazard ratio 5.64, 95% CI 1.97 to 16.19) and higher age (hazard ratio 1.13, 95% CI 1.04 to 1.22) were significantly associated with shorter time to recurrence. CONCLUSIONS: PSA greater than 10 ng./ml., tumor volume greater than 20% and age are significant predictors of recurrence after radical retropubic prostatectomy in patients with prostate cancer and seminal vesicle invasion. Hopefully future randomized trials may show a survival benefit of adjuvant therapy in patients at high risk. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/12478125/Biochemical_and_pathological_predictors_of_the_recurrence_of_prostatic_adenocarcinoma_with_seminal_vesicle_invasion_ DB - PRIME DP - Unbound Medicine ER -