Analysis of predictors and clinical outcomes of seminal vesicle invasion at time of radical prostatectomy with curative intent - A contemporary cohort
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Retrospective analysis was conducted on men who underwent radical prostatectomy (RP) between January of 2003 and April of 2014 by two academic urologic-oncologists in Winnipeg, Manitoba. RP database was created using Manitoba Prostate Center electronic records and Caisis, a web based oncology data manager. Of the 479 RP patients entered 94 (19.7%) had seminal vesicle invasion (SVI). SV positive patients were more likely to have higher preoperative PSA, higher clinical staging, higher Gleason scores and increased cancer total linear distance per core. Many predictors on univariate and multivariate analysis were identified, including but not limited to age at surgery, preoperative PSA, highest Gleason score, percent linear cancer distance and percent cores positive. · Patients with SVI had an increased rate of biochemical failure as compared to SV negative patients (p<0.0001), with a biochemical progression free survival at 1, 3 and 5-years of 78.2%, 60.3% and 45.3% respectively. When SV positive patients were sub-stratified based on pathologic findings it was found that lymph node metastasis was a negative prognostic markers with increased rates of biochemical recurrence (p=O.OOOB). Here we present new data indicating that patients with unilateral SVI compared to patients with bilateral SVI have an increased rate of biochemical progression free survival (p=0.022). Neither positive margins nor extracapsular extension were found to be independent predictors of biochemical recurrence.
seminal vesicle invasion, radical prostatectomy