TITLE:
Tumor Volume Associated with Recurrence in Prostate Cancer Patients with Seminal Vesicle Invasion
AUTHORS:
Paul H. Johnston, Timothy A. Masterson, Liang Cheng, Michael O. Koch
KEYWORDS:
Prostate; Neoplasm; Prostatectomy; Seminal Vesicle Invasion; Recurrence
JOURNAL NAME:
Open Journal of Urology,
Vol.2 No.3A,
October
30,
2012
ABSTRACT: Objectives: To examine predictors of progression-free survival in men with seminal vesicle invasion (SVI) following radical prostatectomy (RP) for clinically localized prostate cancer. Methods and Materials: Between 1999 and 2009, 1383 men underwent RP at Indiana University. Among them, 115 men were identified with SVI. Disease progression was defined by a rise in PSA ≥ 0.2 ng/ml, receipt of salvage therapy, progression to metastatic disease, or death. After excluding 13 patients for receiving adjuvant therapy, 102 were stratified according to surgical margin (SM) and lymph node (LN) status for Kaplan-Meier analysis of disease progression. Cox proportional hazards analyses of biochemical progression-free survival were undertaken with respect to margin status, pre-operative prostate specific antigen (PSA), tumor volume, age, and post-operative Gleason sum. Stem and leaf plot was undertaken for tumor volume by biochemical PFS. Results: Mean age was 61 years, median Gleason sum was 7, mean tumor volume was 9.7 ml, and mean pre-operative PSA was 13.6 ng/ml. Mean time to disease progression was 17 months. Mean follow-up was 37 months. Kaplan-Meier analysis revealed statistically insignificant differences in progression-free survival stratified by SM and LN status (p = 0.12). Cox univariate analyses revealed tumor volume to be a statistically significant predictor of progression free survival (p = 0.02). Stem and Leaf plot revealed tumor volume to be statistically significantly larger in patients who experienced biochemical recurrence, compared to those who did not. Conclusion: Tumor volume was associated progression-free survival in this cohort of SVI patients, while pathologic Gleason sum, PSA, margin and nodal status were not.