Validation of lymphovascular invasion is an independent prognostic factor for biochemical recurrence after radical prostatectomy.
Détails
ID Serval
serval:BIB_B6DDD7225AF7
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Validation of lymphovascular invasion is an independent prognostic factor for biochemical recurrence after radical prostatectomy.
Périodique
Urologic oncology
ISSN
1873-2496 (Electronic)
ISSN-L
1078-1439
Statut éditorial
Publié
Date de publication
05/2016
Peer-reviewed
Oui
Volume
34
Numéro
5
Pages
233.e1-6
Langue
anglais
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Publication Status: ppublish
Résumé
To validate the impact of lymphovascular invasion (LVI) on biochemical recurrence (BCR) in patients treated with radical prostatectomy (RP) in a large multiinstitutional cohort.
Retrospective data from 6,678 patients treated with a RP and bilateral lymphadenectomy for prostate cancer (PC) from 8 centers were collected. The primary endpoint was BCR.
Overall, 767 patients (11.5%) had LVI. Patients with LVI had significantly higher Gleason scores (P = 0.01). After a median follow-up of 28 months (interquartile range: 21-44), patients with LVI had a 1.66 fold increased risk of BCR (P<0.001). The 1-, 2- and 5-year biochemical recurrence-free survival probabilities for LVI vs. no LVI were 94% vs. 97%, 91% vs. 94%, and 76% vs. 84%, respectively. On multivariable analysis that adjusted for the effects of established prognostic factors, LVI was an independent predictor of BCR (hazard ratio = 1.42, P<0.001). Adding LVI to a multivariable base model increased the discrimination by a small but significant margin (+0.2%, P = 0.0005). In subgroup analyses, LVI remained an independent predictor for BCR in patients with worse pathological features.
About 10% of patients with localized PC have LVI on their RP specimen. We confirm that LVI is associated with features of biologic aggressive PC such as high Gleason grade and BCR after RP. Adverse further studies with strict definitions of LVI and longer follow-up periods are needed to determine the prognostic and predictive utility of LVI in the management of PC.
Retrospective data from 6,678 patients treated with a RP and bilateral lymphadenectomy for prostate cancer (PC) from 8 centers were collected. The primary endpoint was BCR.
Overall, 767 patients (11.5%) had LVI. Patients with LVI had significantly higher Gleason scores (P = 0.01). After a median follow-up of 28 months (interquartile range: 21-44), patients with LVI had a 1.66 fold increased risk of BCR (P<0.001). The 1-, 2- and 5-year biochemical recurrence-free survival probabilities for LVI vs. no LVI were 94% vs. 97%, 91% vs. 94%, and 76% vs. 84%, respectively. On multivariable analysis that adjusted for the effects of established prognostic factors, LVI was an independent predictor of BCR (hazard ratio = 1.42, P<0.001). Adding LVI to a multivariable base model increased the discrimination by a small but significant margin (+0.2%, P = 0.0005). In subgroup analyses, LVI remained an independent predictor for BCR in patients with worse pathological features.
About 10% of patients with localized PC have LVI on their RP specimen. We confirm that LVI is associated with features of biologic aggressive PC such as high Gleason grade and BCR after RP. Adverse further studies with strict definitions of LVI and longer follow-up periods are needed to determine the prognostic and predictive utility of LVI in the management of PC.
Mots-clé
Aged, Blood Vessels/pathology, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Lymph Node Excision/methods, Lymph Nodes/pathology, Lymphatic Metastasis, Male, Middle Aged, Multivariate Analysis, Neoplasm Grading, Neoplasm Invasiveness, Neoplasm Recurrence, Local, Outcome Assessment (Health Care)/methods, Outcome Assessment (Health Care)/statistics & numerical data, Prognosis, Proportional Hazards Models, Prostate/pathology, Prostate/surgery, Prostatectomy/methods, Prostatic Neoplasms/pathology, Prostatic Neoplasms/surgery, Retrospective Studies
Pubmed
Création de la notice
17/03/2016 17:54
Dernière modification de la notice
20/08/2019 15:25