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PROGNOSTIC VALUE OF MICROVASCULAR AND PERINEURAL INVASION IN PATIENTS WITH PROSTATE CANCER PT1-4N0-1M0 WHO UNDERWENT RADICAL PROSTATECTOMY

Oncourology

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Title PROGNOSTIC VALUE OF MICROVASCULAR AND PERINEURAL INVASION IN PATIENTS WITH PROSTATE CANCER PT1-4N0-1M0 WHO UNDERWENT RADICAL PROSTATECTOMY
ПРОГНОСТИЧЕСКОЕ ЗНАЧЕНИЕ ПЕРИНЕВРАЛЬНОЙ И АНГИОЛИМФАТИЧЕСКОЙ ИНВАЗИИ У БОЛЬНЫХ РАКОМ ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫ PT1-4N0-1M0, ПОДВЕРГНУТЫХ РАДИКАЛЬНОЙ ПРОСТАТЭКТОМИИ
 
Creator V. Matveev B.; N.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, Moscow
M. Volkova I.; N.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, Moscow
A. Mitin A.; N.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, Moscow
V. Ermilova D.; N.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, Moscow
В. Матвеев Б.; ГУ РОНЦ им. Н.Н. Блохина РАМН, Москва
М. Волкова И.; ГУ РОНЦ им. Н.Н. Блохина РАМН, Москва
А. Митин А.; ГУ РОНЦ им. Н.Н. Блохина РАМН, Москва
В. Ермилова Д.; ГУ РОНЦ им. Н.Н. Блохина РАМН, Москва
 
Subject prostate cancer; radical prostatectomy; perineural and microvascular invasion; recurrence development; overall and specific survival
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Description Objective: to evaluate the prognostic value of microvascular and perineural invasion on radical prostatectomy specimens in prostate cancer patients. Subjects: 144 patients with prostate cancer pT1-4N0-1M0 underwent radical prostatectomy at the Cancer Center in 1997 to 2008. The median age was 60.06.4 (43-73) years. The median preoperative PSA level was 10.413.7 (0.8-95.7) ng/ml (PSA<10 ng/ml; n = 67 (46.5%), PSA ≥10 ng/ml; n = 77 (53.5%). Histological study verified adenocarcinoma in all specimens. The median Gleason score was 6.01.4 (Gleason score <7; n = 112 (77.8%), Gleason score ≥7; n = 32 (22.2%)). Extracapsular tumor extension was revealed in 47 (32.6%), seminal vesicle invasion in 13 (9.0%), regional lymph node metastases in 9 (6.3%), positive margin in 9 (6.3%), microvascular invasion in 58 (40.3%), perineural invasion in 61 (42.4%) of the 144 cases. The median follow-up was 36.615.2 months. Results: microvascular invasion was associated with an increase of Gleason score≥7 rate from 15.1 to 32.8% (p=0.015), extracapsular extension rate from 17.4 to 55.2% (p<0.0001), seminal vesicle invasion rate from 1.2 to 20.7% (p<0.0001) and category N+ rate from 3.5 to 10.3% (p=0.095). Perineural invasion was associated with an increase of extracapsular extension rate from 19.3 to 50.8% (p<0.0001) and seminal vesicle invasion rate from 0.0 to 21.3% (p<0.0001). Microvascular and perineural invasion did not influence positive margin rate (p>0.05). Prostate cancer recurrence developed in 19 (13.2%) of the 144 patients. Relapses were registered more frequently in patients with microvascular (from 8.1 to 20.7% respectively, p=0.028) and perineural (from 8.4 to 19.7% respectively; p=0.043) invasion. Five-year overall, specific and PSA recurrence-free survival in a group of 144 patients was 97.6, 98.3, and 82.1%, respectively. Microvascular invasion significantly decreased 5-year PSA recurrence-free survival from 90.0 to 66.8% (p=0.050), but this difference did not translate into a statistically significant reduction in overall (98.8 and 96.0%, respectively, p=0.812) and specific (100.0 and 96.0% respectively, p=0.251) survival. Perineural invasion was associated with a significant decrease in 5-year PSA recurrence-free survival from 92.4 to 68.2% (p=0.045). Overall (100.0% and 94.1% respectively, p=0.090) and specific (100.0% and 95.7% respectively, p=0.217) survival differences between the groups without and with perineural invasion did not reach statistical significance. Conclusion: microvascular and perineural invasion is associated with the worst pathological findings in prostatectomy specimens, higher recurrence rate and lower PSA recurrence-free survival in patients with prostate cancer pT1-4N0-1M0.
Objective: to evaluate the prognostic value of microvascular and perineural invasion on radical prostatectomy specimens in prostate cancer patients. Subjects: 144 patients with prostate cancer pT1-4N0-1M0 underwent radical prostatectomy at the Cancer Center in 1997 to 2008. The median age was 60.06.4 (43-73) years. The median preoperative PSA level was 10.413.7 (0.8-95.7) ng/ml (PSA<10 ng/ml; n = 67 (46.5%), PSA ≥10 ng/ml; n = 77 (53.5%). Histological study verified adenocarcinoma in all specimens. The median Gleason score was 6.01.4 (Gleason score <7; n = 112 (77.8%), Gleason score ≥7; n = 32 (22.2%)). Extracapsular tumor extension was revealed in 47 (32.6%), seminal vesicle invasion in 13 (9.0%), regional lymph node metastases in 9 (6.3%), positive margin in 9 (6.3%), microvascular invasion in 58 (40.3%), perineural invasion in 61 (42.4%) of the 144 cases. The median follow-up was 36.615.2 months. Results: microvascular invasion was associated with an increase of Gleason score≥7 rate from 15.1 to 32.8% (p=0.015), extracapsular extension rate from 17.4 to 55.2% (p<0.0001), seminal vesicle invasion rate from 1.2 to 20.7% (p<0.0001) and category N+ rate from 3.5 to 10.3% (p=0.095). Perineural invasion was associated with an increase of extracapsular extension rate from 19.3 to 50.8% (p<0.0001) and seminal vesicle invasion rate from 0.0 to 21.3% (p<0.0001). Microvascular and perineural invasion did not influence positive margin rate (p>0.05). Prostate cancer recurrence developed in 19 (13.2%) of the 144 patients. Relapses were registered more frequently in patients with microvascular (from 8.1 to 20.7% respectively, p=0.028) and perineural (from 8.4 to 19.7% respectively; p=0.043) invasion. Five-year overall, specific and PSA recurrence-free survival in a group of 144 patients was 97.6, 98.3, and 82.1%, respectively. Microvascular invasion significantly decreased 5-year PSA recurrence-free survival from 90.0 to 66.8% (p=0.050), but this difference did not translate into a statistically significant reduction in overall (98.8 and 96.0%, respectively, p=0.812) and specific (100.0 and 96.0% respectively, p=0.251) survival. Perineural invasion was associated with a significant decrease in 5-year PSA recurrence-free survival from 92.4 to 68.2% (p=0.045). Overall (100.0% and 94.1% respectively, p=0.090) and specific (100.0% and 95.7% respectively, p=0.217) survival differences between the groups without and with perineural invasion did not reach statistical significance. Conclusion: microvascular and perineural invasion is associated with the worst pathological findings in prostatectomy specimens, higher recurrence rate and lower PSA recurrence-free survival in patients with prostate cancer pT1-4N0-1M0.
 
Publisher "PH "ABV-Press"", LLC
 
Contributor —
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Date 2014-07-24
 
Type info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
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Format application/pdf
 
Identifier http://oncourology.abvpress.ru/index.php/oncur/article/view/15
 
Source Oncourology; № 1 (2010); 33-38
Онкоурология; № 1 (2010); 33-38
1726-9776
 
Language rus
 
Relation http://oncourology.abvpress.ru/index.php/oncur/article/view/15/30
 
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