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- Title
Lymphovascular invasion in prostate cancerThe views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Army, Navy, Department of Defense, or the US Government.This article is a US government work and, as such, is in the public domain in the United States of America.Presented in part at the 2005 American Society of Clinical Oncology Prostate Cancer Symposium, Orlando, Florida, February 17–19, 2005.: Prognostic significance in patients treated with radiotherapy after radical prostatectomy
- Authors
Joseph P. Brooks; Paul S. Albert; John O'Connell; David G. McLeod; Matthew M. Poggi
- Abstract
Lymphovascular invasion (LVI) is found in approximately 5% to 53% of specimens after radical prostatectomy (RP). Although LVI is associated with higher rates of recurrence after RP, its prognostic significance after postprostatectomy radiotherapy (P‐XRT) is unclear.The medical records of men who received P‐XRT from 1991 to 2001 at 2 institutions were reviewed for the presence of LVI in RP specimens. Multiple patient variables were evaluated for their association with LVI using Fisher exact tests and Wilcoxon rank‐sum tests. The time to biochemical recurrence (BCR) and the time to distant metastases (DM) after RP were analyzed using Kaplan–Meier estimations, log‐rank tests, and Cox regression analyses.Eighteen of 160 patients (11%) who received P‐XRT had LVI in their RP specimen. High Gleason score and seminal vesicle invasion were associated significantly with LVI. After a median follow‐up of 8.3 years after RP, 16 patients with LVI had BCR after P‐XRT, 9 of whom developed DM. The median time to BCR in patients with LVI was 2.6 years (95% confidence interval [95% CI], 1.8‐5.4) compared with 7.8 years (95% CI, 6.8‐10.3) in patients without LVI (P < .001). Multivariate analysis revealed an adjusted relative risk for LVI of 5.5 (P < .001). Other significant factors were Gleason score, undetectable post‐RP serum prostate‐specific antigen (PSA) levels, preradiotherapy serum PSA levels, and the interval from RP to P‐XRT. LVI was the only significant factor associated with an increased risk of DM in univariate analysis (hazard ratio, 7.4; P < .001).LVI was useful as a pathologic marker for reduced efficacy of P‐XRT after RP in terms of increased risk of BCR and DM. Future studies will be needed to validate these findings. Cancer 2006. Published 2006 American Cancer Society.
- Subjects
PROSTATECTOMY; PROSTATE surgery; PROGNOSIS; RADIOTHERAPY; METASTASIS; REGRESSION analysis
- Publication
Cancer (0008543X), 2006, Vol 106, Issue 7, p1521
- ISSN
0008-543X
- Publication type
Article