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Cancer Research and Treatment > Accepted Articles
doi: https://doi.org/10.4143/crt.2023.1264    [Accepted]
Bilateral Seminal Vesicle Invasion as a Strong Prognostic Indicator in T3b Prostate Cancer Patients Following Radical Prostatectomy: A Comprehensive, Multi-Center, Long-Term Follow-Up Study
Jungyo Suh1 , In Gab Jeong1 , Hwang Gyun Jeon2, Chang Wook Jeong3, Sangchul Lee4, Seong Soo Jeon2 , Seok Soo Byun4, Cheol Kwak3, Hanjong Ahn1
1Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
2Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
3Department of Urology, Seoul National University Hospital, Seoul, Korea
4Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea
Correspondence  In Gab Jeong ,Tel: 82-2-3010-5892, Fax: 82-2-477-8928, Email: igjeong@amc.seoul.kr
Seong Soo Jeon ,Email: seongsoo.jeon@samsung.com
Received: November 29, 2023;  Accepted: January 4, 2024.  Published online: January 5, 2024.
ABSTRACT
Purpose
Pathologic T3b (pT3b) prostate cancer, characterized by seminal vesicle invasion (SVI), exhibits variable oncological outcomes post-radical prostatectomy (RP). Identifying prognostic factors is crucial for patient-specific management. This study investigates the impact of bilateral SVI on prognosis in pT3b prostate cancer.
Materials and Methods
We evaluated the medical records of a multi-institutional cohort of men who underwent RP for prostate cancer with SVI between 2000 and 2012. Univariate and multivariable analyses were performed using Kaplan-Meier analysis and covariate-adjusted Cox-proportional hazard regression for biochemical recurrence (BCR), clinical progression (CP), and cancer-specific survival (CSS).
Results
Among 770 men who underwent RP without neo-adjuvant treatment, median follow-up was 85.7 months. Patients with bilateral SVI had higher preoperative prostate-specific antigen levels and clinical T stage (all p<0.001). Extracapsular extension, tumor volume, lymph node metastasis (p<0.001), pathologic Gleason grade group (p<0.001), and resection margin positivity (p<0.001) were also higher in patients with bilateral SVI. The 5-, 10-, and 15-year BCR-free survival rates were 23.9%, 11.7%, and 8.5%; CP-free survival rates were 82.8%, 62.5%, and 33.4%; and CSS rates were 96.4%, 88.1%, and 69.5%, respectively. The bilateral SVI group demonstrated significantly lower BCR, CP-free survival rates, and CSS rates all (p<0.001). Bilateral SVI was independently associated with BCR (HR 1.197, 95% CI 1p=0.049), CP (p=0.022), and CSS (p=0.038) in covariate-adjusted Cox regression.
Conclusion
Bilateral SVI is a robust, independent prognostic factor for poor oncological outcomes in pT3b prostate cancer.
Key words: Prostatic neoplasms, Prostatectomy, Seminal vesicle invasion
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