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- Title
The Clinical Impact of Unilateral Versus Bilateral Invasion Into the Seminal Vesicle in Patients With Prostate Cancer Undergoing Radical Prostatectomy.
- Authors
Numbere, Numbereye; Yuki Teramoto; Gurung, Pratik M. S.; Ying Wang; Zhiming Yang; Hiroshi Miyamoto
- Abstract
Context.--Seminal vesicle involvement by prostate cancer has generally been considered as a key prognosticator. Objective.--To assess the clinical significance of unilateral (Uni) versus bilateral (Bil) seminal vesicle invasion (SVI). Design.--We compared radical prostatectomy findings and long-term oncologic outcomes in 248 patients showing Uni-SVI (n = 139) versus Bil-SVI (n ¼ 109). Results.--Tumor grade was significantly higher in Bil-SVI cases than in Uni-SVI cases. Additionally, Bil-SVI was significantly associated with a higher incidence of lymphovascular invasion, lymph node metastasis, or positive surgical margin, and larger estimated tumor volume. When the histopathologic features at SVI foci were compared, Grade Group (GG) 3-5/4-5/5 and cribriform morphology were significantly more often seen in Bil-SVI. Outcome analysis revealed that patients with Bil-SVI had a significantly higher risk of disease progression (P < .001) than patients with Uni-SVI. Significantly worse progression-free survival in patients with Bil-SVI was also observed in all subgroups examined, including those with no immediate adjuvant therapy (IAT) (n=139; P=.01), IAT (n=109; P= .001), pN0 disease (n=153; P=.002), or pN1 disease (n= 93; P = .006). In multivariate analysis, Bil-SVI (versus Uni-SVI) showed significance for progression in the entire (hazard ratio [HR] = 1.83, P = .01), IAT (HR = 2.90, P = .006), and pN0 (HR = 2.05, P = .01) cohorts. Meanwhile, tumor grade at SVI (eg, GG4, GG5), as an independent predictor, was significantly associated with patient outcomes. Conclusions.--Bil-SVI was found to be strongly associated with worse histopathologic features on radical prostatectomy and poorer prognosis. Pathologists may thus need to report Uni-SVI versus Bil-SVI, along with other histopathologic findings, such as Gleason score, at SVI in prostatectomy specimens.
- Subjects
DISEASE progression; PROSTATECTOMY; CANCER invasiveness; MULTIVARIATE analysis; TREATMENT effectiveness; MALE reproductive organs; PROGRESSION-free survival; PROSTATE tumors
- Publication
Archives of Pathology & Laboratory Medicine, 2022, Vol 146, Issue 7, p855
- ISSN
0003-9985
- Publication type
Article
- DOI
10.5858/arpa.2021-0265-OA