Seminal vesicle invasion: what is the best adjuvant treatment after radical prostatectomy?

Bastide, C.; Rossi, D.; Lechevallier, É.; Bladou, Franck; Barriol, D.; Bretheau, D; Grisoni, Vincent; Mancini, Julien; Giusiano, Sophie; Eghazarian, C.; Hove, A. Van

doi:10.1111/j.1464-410x.2011.10332.x

Cited by 23 publications

(26 citation statements)

References 26 publications

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“…In an attempt to determine the optimal treatment for patients with SVI after RP, Bastide and colleagues evaluated BCR according to different adjuvant treatments. They report that RP appears to be insufficient as monotherapy in patients with SVI, however ADT in combination with adjuvant RT provided substantial biochemical control benefit 8 .…”

Section: Discussionmentioning

confidence: 99%

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African-American Race Is a Predictor of Seminal Vesicle Invasion After Radical Prostatectomy

Yamoah

Walker

Spangler

et al. 2015

Clinical Genitourinary Cancer

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Purpose Whether racial differences exist in the pattern of local disease progression among men treated with radical prostatectomy (RP) for localized prostate cancer (PCa) is currently unknown. In this study we evaluate the pattern of adverse pathologic features in an identical cohort of AA and Caucasian (CS) men with PCa. Methods The overall cohort consisted of 1,104 men (224 AA, and 880 CS) who underwent RP between 1990 and 2012. We compared preoperative factors and pathologic outcomes following RP across race groups. Multivariate analysis was used to identify factors predictive of adverse pathologic outcomes. The impact of race on adverse pathologic outcomes and biochemical control rate (BCR) was evaluated using multivariate regression model and Kaplan-Meier analysis. Results The 10-year BCR was 59 % vs. 82% in AA and CS men, respectively (p=0.003). There was no significant difference in extraprostatic spread (EPE; p = 0.14), positive surgical margin (SM; p = 0.81), lymph node involvement (LNI: p = 0.71) or adverse pathologic features (p = 0.16) across race groups. However, among patients with ≥1 adverse pathologic features, AA men had higher rate of seminal vesicle invasion (SVI) as compared with CS men (51% vs 30%; P = 0.01). Upon adjusting for known predictors of adverse pathologic features AA race remained a predictor of SVI. Conclusions AA men have increased risk of SVI following RP, particularly among men with Gleason ≤6 disease. This may represent racial differences in the biology of PCa disease progression contributing to poorer outcomes in AA men.

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Section: Discussionmentioning

confidence: 99%

“…They demonstrated that AA men had a significantly higher prevalence of anterior cancer foci of higher grade and larger volume as compared to Caucasian men 8 . Whether differing patterns of local disease progression between race groups may account for worse outcomes in AA men following RP is currently unknown.…”

Section: Introductionmentioning

confidence: 99%

African-American Race Is a Predictor of Seminal Vesicle Invasion After Radical Prostatectomy

Yamoah

Walker

Spangler

et al. 2015

Clinical Genitourinary Cancer

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“…However, the 10-yr OS was similar between groups (75% vs. 69%, P = 0.12). A cohort study by Bastide et al also compared the use of RP ( N = 82) with RP plus aADT ( N = 41) for pT3bN0M0 patients23. Multivariate analysis showed that the combined group had a lower PSA-biochemical recurrence rate (HR 0.64, P = 0.13).…”

Section: Resultsmentioning

confidence: 99%

“…ADT use before surgery or radiotherapy was based on “the first hypothesis” that androgen ablation might reduce the tumor bulk and enhance tumor cell kill to enable total excision of the cancerous area, whereas ADT use after surgery or radiotherapy might eliminate residual tumor cells in the primary lesions and subclinical metastatic lesions (called “the second hypothesis”). Studies by Siddiqui et al22 and Bastide et al23 demonstrated that nADT before RP could improve long-term survival outcomes. However, both these studies included only high-risk patients with seminal vesicle invasion (pT3b); therefore, we cannot reach the same conclusion for localized PCa patients with clinical stage ≥ T2c, Gleason 8–10, or PSA>20 ng/ml.…”

Section: Discussionmentioning

confidence: 99%

Systematic Review and Meta-analysis of the Survival Outcomes of First-line Treatment Options in High-risk Prostate Cancer

Lei

Liu

Wang

et al. 2015

Sci Rep

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Prostate cancer (PCa) is the most common non-dermatologic cancer in the western countries in western countries. High-risk PCa accounts for 15% of the diagnosed cases. In this study, we compare the long-term survival outcomes of radical prostatectomy (RP), radiation therapy (RT), brachytherapy (BT), androgen- deprivation therapy (ADT), and watchful waiting (WW) in high-risk prostate cancer (PCa). Overall, RP/(RT plus ADT) gave the best survival outcome in patients with high-risk PCa, whereas ADT/WW had the worst outcome. The overall priority for treatment strategy could be ranked as follows: RP/(RT plus ADT), RT, and ADT/WW. RP had significant better overall survival (OS) than RT or BT, and RP had significant lower cancer-specific mortality (CSM) than RT (0.51 [95% CI 0.30–0.73], P<0.001). ADT improved the cancer-specific survival (CSS) of RP based on a case-controlled study; added ADT to RT failed to challenge the position of RP but could improve the outcome of RT. In conclusions,RP/(RT plus adjuvant ADT) could both be used for the first-line therapy of high-risk PCa. When encountering an individual patient, urologists should consider various factors like tumors themselves, preferences of individuals, and so on.

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“…SVI in PCa affects both patient prognosis and surgical strategy . In older series, SVI is reported to be as high as 26%; more recent series report SVI ranging from 5 to 9% …”

Section: Introductionmentioning

confidence: 99%

Novel nomogram for the prediction of seminal vesicle invasion including multiparametric magnetic resonance imaging

et al. 2019

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Objectives To create a model that predicts side‐specific seminal vesicle invasion using clinical, biopsy and multiparametric magnetic resonance imaging data. Methods We analyzed data from 544 patients who underwent robot‐assisted radical prostatectomy at a single institution. To develop a side‐specific predictive model, we ultimately considered four variables: prostate‐specific antigen, highest ipsilateral biopsy Gleason grade, highest ipsilateral percentage core involvement and seminal vesicle invasion on multiparametric magnetic resonance imaging. A binary multivariable logistic regression model was fitted to predict seminal vesicle invasion. A nomogram was then built based on the coefficients of the resulting logit function. The leave‐one‐out cross validation method was used for internal validation, and the decision curve analysis for the evaluation of the net clinical benefit. Results We relied on 804 side‐specific cases after excluding negative biopsy observations (n = 284). Seminal vesicle invasion was reported on multiparametric magnetic resonance imaging in 41 (5%) cases, and on final pathology in 64 (8%) cases. All variables in the model emerged as predictors of seminal vesicle invasion (all P ≤ 0.001) and were subsequently considered to build a nomogram. The area under the curve of multiparametric magnetic resonance imaging alone in predicting seminal vesicle invasion was 59.1%; whereas one of the clinical variables only was 85.1%. The area under the curve of the nomogram resulting from their combination was 86.5%. After internal validation, this resulted in 84.7%. The model achieved good calibration and the decision curve analysis showed its clinical benefit, especially when compared with relying only on multiparametric magnetic resonance imaging prediction of seminal vesicle invasion. Conclusions A nomogram based on clinical and multiparametric magnetic resonance imaging data can predict seminal vesicle invasion and serve as a tool to urologists for surgical planning.

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Seminal vesicle invasion: what is the best adjuvant treatment after radical prostatectomy?

Cited by 23 publications

References 26 publications

African-American Race Is a Predictor of Seminal Vesicle Invasion After Radical Prostatectomy

African-American Race Is a Predictor of Seminal Vesicle Invasion After Radical Prostatectomy

Systematic Review and Meta-analysis of the Survival Outcomes of First-line Treatment Options in High-risk Prostate Cancer

Novel nomogram for the prediction of seminal vesicle invasion including multiparametric magnetic resonance imaging

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