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Contemporary survival results and the role of radiation therapy in patients with node negative seminal vesicle invasion following radical prostatectomy.
J Urol. 2005 Apr; 173(4):1150-5.JU

Abstract

PURPOSE

Seminal vesicle invasion (SVI) in a radical prostatectomy (RRP) specimen is associated with a guarded prognosis. We evaluated patients with SVI treated in the pre-prostate specific antigen (PSA) (1983 to 1991) and PSA (1992 to 2003) eras.

MATERIALS AND METHODS

Of patients with prostate cancer treated with RRP from January 1983 through March 2002, 220 with SVI were evaluated, including 67 in the pre-PSA era and 153 in the PSA era. Postoperative PSA greater than 0.2 ng/ml was considered biochemical evidence of cancer progression. Survival rates were compared using Kaplan-Meier estimates to calculate progression-free, cancer specific and all cause survival. Multivariate Cox proportional hazard models were used to correlate variables with disease progression.

RESULTS

The incidence of SVI in the PSA era was lower than in the pre-PSA era (6.0% vs 10.2%, p = 0.001). To date 124 patients (56%) have had evidence of cancer progression. The 4 and 7-year progression-free, cancer specific and all cause survival rates were significantly higher in men with SVI in the PSA era (p = 0.02). PSA at diagnosis, cancerous surgical margins and higher Gleason score were significantly associated with progression. Neither adjuvant nor salvage radiotherapy appeared to confer a significant progression-free survival benefit.

CONCLUSIONS

The incidence of SVI has decreased in the PSA era. Progression-free, cancer specific and all cause survival rates following RRP in patients with SVI have improved in the PSA era. This may reflect earlier detection in this pathological tumor stage and more favorable prognostic factors associated with PSA screening. Adjuvant radiotherapy does not appear to confer any therapeutic benefit. Salvage radiotherapy can lead to durable PSA regressions in a small percent of men, although no long-term survival advantage can be proved.

Authors+Show Affiliations

Eggener SE
Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Roehl KA
No affiliation info available
Smith ND
No affiliation info available
Antenor JA
No affiliation info available
Han M
No affiliation info available
Catalona WJ
No affiliation info available

MeSH

AgedDisease ProgressionDisease-Free SurvivalGenital Neoplasms, MaleHumansLymph Node ExcisionLymphatic MetastasisMaleMiddle AgedNeoplasm InvasivenessNeoplasm Recurrence, LocalNeoplasm StagingPrognosisProportional Hazards ModelsProstate-Specific AntigenProstatectomyProstatic NeoplasmsRadiotherapy, AdjuvantRetrospective StudiesSalvage TherapySeminal VesiclesSurvival Rate

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15758725

Citation

Eggener, Scott E., et al. "Contemporary Survival Results and the Role of Radiation Therapy in Patients With Node Negative Seminal Vesicle Invasion Following Radical Prostatectomy." The Journal of Urology, vol. 173, no. 4, 2005, pp. 1150-5.
Eggener SE, Roehl KA, Smith ND, et al. Contemporary survival results and the role of radiation therapy in patients with node negative seminal vesicle invasion following radical prostatectomy. J Urol. 2005;173(4):1150-5.
Eggener, S. E., Roehl, K. A., Smith, N. D., Antenor, J. A., Han, M., & Catalona, W. J. (2005). Contemporary survival results and the role of radiation therapy in patients with node negative seminal vesicle invasion following radical prostatectomy. The Journal of Urology, 173(4), 1150-5.
Eggener SE, et al. Contemporary Survival Results and the Role of Radiation Therapy in Patients With Node Negative Seminal Vesicle Invasion Following Radical Prostatectomy. J Urol. 2005;173(4):1150-5. PubMed PMID: 15758725.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Contemporary survival results and the role of radiation therapy in patients with node negative seminal vesicle invasion following radical prostatectomy. AU - Eggener,Scott E, AU - Roehl,Kimberly A, AU - Smith,Norm D, AU - Antenor,Jo Ann V, AU - Han,Misop, AU - Catalona,William J, PY - 2005/3/11/pubmed PY - 2005/4/7/medline PY - 2005/3/11/entrez SP - 1150 EP - 5 JF - The Journal of urology JO - J Urol VL - 173 IS - 4 N2 - PURPOSE: Seminal vesicle invasion (SVI) in a radical prostatectomy (RRP) specimen is associated with a guarded prognosis. We evaluated patients with SVI treated in the pre-prostate specific antigen (PSA) (1983 to 1991) and PSA (1992 to 2003) eras. MATERIALS AND METHODS: Of patients with prostate cancer treated with RRP from January 1983 through March 2002, 220 with SVI were evaluated, including 67 in the pre-PSA era and 153 in the PSA era. Postoperative PSA greater than 0.2 ng/ml was considered biochemical evidence of cancer progression. Survival rates were compared using Kaplan-Meier estimates to calculate progression-free, cancer specific and all cause survival. Multivariate Cox proportional hazard models were used to correlate variables with disease progression. RESULTS: The incidence of SVI in the PSA era was lower than in the pre-PSA era (6.0% vs 10.2%, p = 0.001). To date 124 patients (56%) have had evidence of cancer progression. The 4 and 7-year progression-free, cancer specific and all cause survival rates were significantly higher in men with SVI in the PSA era (p = 0.02). PSA at diagnosis, cancerous surgical margins and higher Gleason score were significantly associated with progression. Neither adjuvant nor salvage radiotherapy appeared to confer a significant progression-free survival benefit. CONCLUSIONS: The incidence of SVI has decreased in the PSA era. Progression-free, cancer specific and all cause survival rates following RRP in patients with SVI have improved in the PSA era. This may reflect earlier detection in this pathological tumor stage and more favorable prognostic factors associated with PSA screening. Adjuvant radiotherapy does not appear to confer any therapeutic benefit. Salvage radiotherapy can lead to durable PSA regressions in a small percent of men, although no long-term survival advantage can be proved. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/15758725/Contemporary_survival_results_and_the_role_of_radiation_therapy_in_patients_with_node_negative_seminal_vesicle_invasion_following_radical_prostatectomy_ DB - PRIME DP - Unbound Medicine ER -