Skip to main content
SpringerLink
Log in

Prognostic Significance of Vas Deferens Invasion After Radical Prostatectomy in Patients with Pathological Stage T3b Prostate Cancer

  • Urologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Seminal vesicle invasion (SVI) is associated with adverse clinical outcomes in prostate cancer (PCa) patients. Despite its anatomical similarity and close proximity to the seminal vesicle, the prognostic significance of vas deferens invasion (VDI) by PCa has not been elucidated. For these reasons, we investigated the impact of VDI on the oncological outcome of pT3b PCa in association with SVI.

Methods

We retrospectively reviewed the medical records of 3359 patients who had undergone a radical prostatectomy at our institution between January 2000 and December 2014 for PCa. Patients who received neoadjuvant or adjuvant treatment (radiation, androgen deprivation therapy, or both) and those without adequate medical records were excluded. A Kaplan–Meier analysis was performed to analyze biochemical recurrence-free survival (BCRFS), and a Cox regression model was used to test the influence of VDI on biochemical recurrence (BCR).

Results

Of 350 patients with pathologically confirmed SVI (pT3b), 87 (24.9%) had VDI, while the remaining 263 patients (75.1%) had isolated SVI. Compared with SVI patients without VDI, SVI patients with VDI were noted to have a significantly worse 5-year BCRFS (25.1 vs. 17.1%, respectively). VDI was a significant predictor of BCR in multivariate Cox regression analysis (hazard ratio 1.39, 95% confidence interval 1.02–1.90; p = 0.039).

Conclusions

Our results shows that the prognosis of PCa with SVI might be further stratified by VDI status, thus suggesting the role of VDI either as a surrogate for poor prognosis or as a determinant for adjuvant therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Potter SR, Epstein JI, Partin AW. Seminal vesicle invasion by prostate cancer: prognostic significance and therapeutic implications. Rev Urol. 2000;2:190–5.

    CAS  PubMed  PubMed Central  Google Scholar 

  2. Ohori M, Scardino PT, Lapin SL, Seale-Hawkins C, Link J, Wheeler TM. The mechanisms and prognostic significance of seminal vesicle involvement by prostate cancer. Am J Surg Pathol. 1993;17:1252–61.

    Article  CAS  PubMed  Google Scholar 

  3. Villers AA, McNeal JE, Redwine EA, Freiha FS, Stamey TA. Pathogenesis and biological significance of seminal vesicle invasion in prostatic adenocarcinoma. J Urol. 1990;143:1183–7.

    CAS  PubMed  Google Scholar 

  4. Yigit N, Karslioglu Y, Kurt B. Vas deferens invasion: a neglected issue in the sampling of radical prostatectomy materials. Can Urol Assoc J. 2014;8:E554–7.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Berney DM, Wheeler TM, Grignon DJ, et al. International Society of Urological Pathology (ISUP) consensus conference on handling and staging of radical prostatectomy specimens. Working group 4: seminal vesicles and lymph nodes. Mod Pathol. 2011;24:39–47.

  6. Saar M, Kamradt J, Sauer C, Stockle M, Grobholz R. Margin status of the vas deferens in radical prostatectomy specimens: relevant or waste of time? Histopathology. 2014;65:45–50.

    Article  PubMed  Google Scholar 

  7. Zakian KL, Hatfield W, Aras O, et al. Prostate MRSI predicts outcome in radical prostatectomy patients. Magn Reson Imaging. 2016;34:674–81.

    Article  PubMed  Google Scholar 

  8. Koo KC, Tuliao P, Komninos C, et al. Prognostic impact of time to undetectable prostate-specific antigen in patients with positive surgical margins following radical prostatectomy. Ann Surg Oncol. 2015;22:693–700.

    Article  PubMed  Google Scholar 

  9. Huang CC, Deng FM, Kong MX, Ren Q, Melamed J, Zhou M. Re-evaluating the concept of “dominant/index tumor nodule” in multifocal prostate cancer. Virchows Arch. 2014;464:589–94.

    Article  CAS  PubMed  Google Scholar 

  10. Chen ME, Johnston DA, Tang K, Babaian RJ, Troncoso P. Detailed mapping of prostate carcinoma foci: biopsy strategy implications. Cancer. 2000;89:1800–9.

    Article  CAS  PubMed  Google Scholar 

  11. Cronin AM, Godoy G, Vickers AJ. Definition of biochemical recurrence after radical prostatectomy does not substantially impact prognostic factor estimates. J Urol. 2010;183:984–9.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Freedland SJ, Aronson WJ, Presti JC, Jr., et al. Predictors of prostate-specific antigen progression among men with seminal vesicle invasion at the time of radical prostatectomy. Cancer. 2004;100:1633–8.

    Article  PubMed  Google Scholar 

  13. Salomon L, Anastasiadis AG, Johnson CW, et al. Seminal vesicle involvement after radical prostatectomy: predicting risk factors for progression. Urology. 2003;62:304–9.

    Article  PubMed  Google Scholar 

  14. Debras B, Guillonneau B, Bougaran J, Chambon E, Vallancien G. Prognostic significance of seminal vesicle invasion on the radical prostatectomy specimen. Rationale for seminal vesicle biopsies. Eur Urol. 1998;33:271–7.

    Article  CAS  PubMed  Google Scholar 

  15. Srigley JR, Humphrey PA, Amin MB, et al. Protocol for the examination of specimens from patients with carcinoma of the prostate gland. Arch Pathol Lab Med. 2009;133:1568–76.

    PubMed  Google Scholar 

  16. Epstein JI, Partin AW, Potter SR, Walsh PC. Adenocarcinoma of the prostate invading the seminal vesicle: prognostic stratification based on pathologic parameters. Urology. 2000;56:283–8.

    Article  CAS  PubMed  Google Scholar 

  17. Billis A, Teixeira DA, Stelini RF, Quintal MM, Guimaraes MS, Ferreira U. Seminal vesicle invasion in radical prostatectomies: which is the most common route of invasion? Int Urol Nephrol. 2007;39:1097–102.

    Article  PubMed  Google Scholar 

  18. Nguyen DP, Giannarini G, Seiler R, et al. Local recurrence after retropubic radical prostatectomy for prostate cancer does not exclusively occur at the anastomotic site. BJU Int. 2013;112:E243–9.

    Article  PubMed  Google Scholar 

  19. Kristiansen A, Wiklund F, Wiklund P, Egevad L. Prognostic significance of patterns of seminal vesicle invasion in prostate cancer. Histopathology. 2013;62:1049–56.

    Article  PubMed  Google Scholar 

  20. Bottke D, Bartkowiak D, Schrader M, Wiegel T. Radiotherapy after radical prostatectomy: immediate or early delayed? Strahlenther Onkol. 2012;188:1096–101.

    Article  CAS  PubMed  Google Scholar 

  21. Thompson IM, Tangen CM, Paradelo J, et al. Adjuvant radiotherapy for pathological T3N0M0 prostate cancer significantly reduces risk of metastases and improves survival: long-term followup of a randomized clinical trial. J Urol. 2009;181:956–62.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Heidenreich A, Bellmunt J, Bolla M, et al. EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and treatment of clinically localised disease. Eur Urol. 2011;59:61–71.

    Article  PubMed  Google Scholar 

  23. Bolla M, van Poppel H, Collette L, et al. Postoperative radiotherapy after radical prostatectomy: a randomised controlled trial (EORTC trial 22911). Lancet. 2005;366:572–8.

    Article  PubMed  Google Scholar 

  24. Thompson IM Jr, Tangen CM, Paradelo J, et al. Adjuvant radiotherapy for pathologically advanced prostate cancer: a randomized clinical trial. JAMA. 2006;296:2329–35.

    Article  CAS  PubMed  Google Scholar 

  25. Wiegel T, Bottke D, Steiner U, et al. Phase III postoperative adjuvant radiotherapy after radical prostatectomy compared with radical prostatectomy alone in pT3 prostate cancer with postoperative undetectable prostate-specific antigen: ARO 96-02/AUO AP 09/95. J Clin Oncol. 2009;27:2924–30.

    Article  PubMed  Google Scholar 

  26. Kim SP, Tilburt JC, Karnes RJ, et al. Variation in treatment recommendations of adjuvant radiation therapy for high-risk prostate cancer by physician specialty. Urology. 2013;82:807–12.

    Article  PubMed  Google Scholar 

  27. Showalter TN, Ohri N, Teti KG, et al. Physician beliefs and practices for adjuvant and salvage radiation therapy after prostatectomy. Int J Radiat Oncol Biol Phys. 2012;82:e233–8.

    Article  PubMed  Google Scholar 

  28. Johansson JE, Andren O, Andersson SO, et al. Natural history of early, localized prostate cancer. JAMA. 2004;291:2713–9.

    Article  CAS  PubMed  Google Scholar 

  29. Stephenson AJ, Kattan MW, Eastham JA, et al. Defining biochemical recurrence of prostate cancer after radical prostatectomy: a proposal for a standardized definition. J Clin Oncol. 2006;24:3973–8.

    Article  CAS  PubMed  Google Scholar 

  30. Freedland SJ, Humphreys EB, Mangold LA, et al. Risk of prostate cancer-specific mortality following biochemical recurrence after radical prostatectomy. JAMA. 2005;294:433–9.

    Article  CAS  PubMed  Google Scholar 

  31. Pound CR, Partin AW, Eisenberger MA, Chan DW, Pearson JD, Walsh PC. Natural history of progression after PSA elevation following radical prostatectomy. JAMA. 1999;281:1591–7.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgement

No sources of funding were needed for this work.

Disclosure

Won Sik Jang, Cheol Yong Yoon, Ki Hong Kim, Yong Jin Kang, Su-Jin Shin, Nam Hoon Cho, Joo Yong Lee, Kang Su Cho, Won Sik Ham, Koon Ho Rha, Sung Joon Hong, and Young Deuk Choi declare no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea

    Won Sik Jang MD, Cheol Yong Yoon MD, PhD, Ki Hong Kim MD, Yong Jin Kang MD, Joo Yong Lee MD, PhD, Kang Su Cho MD, PhD, Won Sik Ham MD, PhD, Koon Ho Rha MD, PhD, Sung Joon Hong MD, PhD & Young Deuk Choi MD, PhD

  2. Department of Pathology, Yonsei University College of Medicine, Seoul, Korea

    Su-Jin Shin MD & Nam Hoon Cho MD, PhD

Authors
  1. Won Sik Jang MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cheol Yong Yoon MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ki Hong Kim MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yong Jin Kang MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Su-Jin Shin MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nam Hoon Cho MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Joo Yong Lee MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Kang Su Cho MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Won Sik Ham MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Koon Ho Rha MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Sung Joon Hong MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Young Deuk Choi MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Young Deuk Choi MD, PhD.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOC 38 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jang, W.S., Yoon, C.Y., Kim, K.H. et al. Prognostic Significance of Vas Deferens Invasion After Radical Prostatectomy in Patients with Pathological Stage T3b Prostate Cancer. Ann Surg Oncol 24, 1143–1149 (2017). https://doi.org/10.1245/s10434-016-5653-x

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-016-5653-x

Keywords

Search

Navigation