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Vascular invasion predicts recurrence after radical prostatectomy: stratification of risk based on pathologic variables.
Urology. 2004 Oct; 64(4):749-53.U

Abstract

OBJECTIVES

To determine whether vascular invasion (VI) is an independent predictor of prostate cancer recurrence and/or survival and to stratify risk of recurrence in patients with VI.

METHODS

Vascular invasion status was documented in 620 radical prostatectomy specimens with an average of 7.5 years of follow-up. The relationship between VI and other clinical and pathologic features was tested. Vascular invasion as an independent predictor of recurrence was investigated by logistic regression analysis. Survival analyses and stratification of VI patients was developed with Kaplan-Meier survival curves.

RESULTS

Vascular invasion was identified in 110 patients (18%) and correlated significantly (P <0.0001) with high Gleason grade, extracapsular extension (EPE), seminal vesicle invasion, increasing cancer volumes, positive margins, and elevated preoperative prostate-specific antigen (PSA) levels. Logistic regression analysis demonstrated that VI was a strong and independent predictor for disease recurrence, when considered with grade, EPE, seminal vesicle invasion, lymph node involvement, cancer volume, preoperative PSA levels, and positive margins. At 12 years after radical prostatectomy, patients with VI demonstrated significantly lower disease-specific survival (P = 0.0005). Among patients with VI, stratification of grade, EPE, and the number of VI foci identified three significantly different prognostic groups.

CONCLUSIONS

In long-term follow-up, VI was a significant predictor of prostate cancer recurrence and death after radical prostatectomy. In patients with VI, high Gleason grade, EPE, and more than five foci of VI are associated with poor prognosis.

Authors+Show Affiliations

Ferrari MK
Department of Urology, Stanford University, Stanford, California, USA.
McNeal JE
No affiliation info available
Malhotra SM
No affiliation info available
Brooks JD
No affiliation info available

MeSH

AdenocarcinomaAdultAgedBiomarkers, TumorDisease-Free SurvivalFollow-Up StudiesHumansLife TablesLymphatic MetastasisMaleMiddle AgedNeoplasm InvasivenessNeoplasm ProteinsNeoplasm Recurrence, LocalPrognosisProstate-Specific AntigenProstatectomyProstatic NeoplasmsRisk AssessmentSeminal VesiclesSurvival Analysis

Pub Type(s)

Evaluation Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15491714

Citation

Ferrari, Michelle K., et al. "Vascular Invasion Predicts Recurrence After Radical Prostatectomy: Stratification of Risk Based On Pathologic Variables." Urology, vol. 64, no. 4, 2004, pp. 749-53.
Ferrari MK, McNeal JE, Malhotra SM, et al. Vascular invasion predicts recurrence after radical prostatectomy: stratification of risk based on pathologic variables. Urology. 2004;64(4):749-53.
Ferrari, M. K., McNeal, J. E., Malhotra, S. M., & Brooks, J. D. (2004). Vascular invasion predicts recurrence after radical prostatectomy: stratification of risk based on pathologic variables. Urology, 64(4), 749-53.
Ferrari MK, et al. Vascular Invasion Predicts Recurrence After Radical Prostatectomy: Stratification of Risk Based On Pathologic Variables. Urology. 2004;64(4):749-53. PubMed PMID: 15491714.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vascular invasion predicts recurrence after radical prostatectomy: stratification of risk based on pathologic variables. AU - Ferrari,Michelle K, AU - McNeal,John E, AU - Malhotra,Sameer M, AU - Brooks,James D, PY - 2004/03/05/received PY - 2004/04/29/revised PY - 2004/04/29/accepted PY - 2004/10/20/pubmed PY - 2005/8/13/medline PY - 2004/10/20/entrez SP - 749 EP - 53 JF - Urology JO - Urology VL - 64 IS - 4 N2 - OBJECTIVES: To determine whether vascular invasion (VI) is an independent predictor of prostate cancer recurrence and/or survival and to stratify risk of recurrence in patients with VI. METHODS: Vascular invasion status was documented in 620 radical prostatectomy specimens with an average of 7.5 years of follow-up. The relationship between VI and other clinical and pathologic features was tested. Vascular invasion as an independent predictor of recurrence was investigated by logistic regression analysis. Survival analyses and stratification of VI patients was developed with Kaplan-Meier survival curves. RESULTS: Vascular invasion was identified in 110 patients (18%) and correlated significantly (P <0.0001) with high Gleason grade, extracapsular extension (EPE), seminal vesicle invasion, increasing cancer volumes, positive margins, and elevated preoperative prostate-specific antigen (PSA) levels. Logistic regression analysis demonstrated that VI was a strong and independent predictor for disease recurrence, when considered with grade, EPE, seminal vesicle invasion, lymph node involvement, cancer volume, preoperative PSA levels, and positive margins. At 12 years after radical prostatectomy, patients with VI demonstrated significantly lower disease-specific survival (P = 0.0005). Among patients with VI, stratification of grade, EPE, and the number of VI foci identified three significantly different prognostic groups. CONCLUSIONS: In long-term follow-up, VI was a significant predictor of prostate cancer recurrence and death after radical prostatectomy. In patients with VI, high Gleason grade, EPE, and more than five foci of VI are associated with poor prognosis. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/15491714/Vascular_invasion_predicts_recurrence_after_radical_prostatectomy:_stratification_of_risk_based_on_pathologic_variables_ DB - PRIME DP - Unbound Medicine ER -
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