The Mechanisms and Prognostic Significance of Seminal Vesicle Involvement by Prostate Cancer

Ohori, Makoto; Scardino, Peter T.; Lapin, Stephen L.; Seale‐Hawkins, Carie; Link, John S.; Wheeler, Thomas M.

doi:10.1097/00000478-199312000-00006

Cited by 199 publications

(105 citation statements)

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“…We previously reported the mechanisms of SVI ( Figure 5). 17 Type I is direct spread along the ejaculatory duct complex into the seminal vesicles. Tumor migration does not occur in the lumen of the ejaculatory ducts; rather it invades along the tissue plane around these structures.…”

Section: Pt3b (Seminal Vesicle Invasion)mentioning

confidence: 99%

Radical prostatectomy for carcinoma of the prostate

et al. 2004

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Morphologic features of prostatic adenocarcinoma in the radical prostatectomy (RP) specimen are powerful prognostic indicators for prognosis for disease-free survival. This review discusses the methods of sampling of the RP specimen to optimize the detection of these morphologic features, balanced against the added expense of submitting the entire gland for sectioning. Gleason grade, one of the most powerful prognostic factors, is discussed briefly, including the percent pattern 4/5 cancer compared to the standard Gleason grading. Pathologic stage, as defined by the TNM system, is discussed in detail, both in terms of precise histological definition of each category, as well as the associated prognostic implications. Surgical margin status is also important prognostically across all pathologic stages categories. Perineural invasion, which has been used diagnostically in prostate cancer for several decades, has emerged as a very important prognostic indicator as well, as determined by the quantitative aspects of tumor in the perineural space. The effect of tumor volume on prognosis is discussed, as well as the newer concepts of the prognostic significance of zone of origin of the tumor and the presence or absence of intraductal carcinoma. Keywords: prostate carcinoma; pathologic stage; radical prostatectomy Radical prostatectomy (RP) for carcinoma of the prostate was performed and reported 100 years ago at the Johns Hopkins hospital by Dr Hugh Hampton Young who utilized a transperineal approach. He reported this and several other cases in the Bulletin of the Johns Hopkins Hospital. 1 Major impediments to utilizing RP in the years that followed related primarily to the almost universal presence of impotence and less commonly incontinence following the surgery. Also a large proportion of cases were first diagnosed with stage IV disease before widespread awareness of the disease and the advent of screening with serum prostate-specific antigen (PSA) in the late 1980s. In addition, initially there were high expectations for hormonal therapy in the 1940s and radiation therapy in the years that followed. However, it became clear very early that hormonal therapy could delay but not halt the progression of disease. Also radiotherapy was fraught with a high frequency of post-therapy positive biopsies and subsequent late recurrence; and for the latter, at times a much less differentiated tumor.The resurgence of RP for prostate cancer was brought about by another surgeon at Johns Hopkins, Patrick Walsh, MD, who along with Donker, reported on the anatomical distribution of nerves to the penile corpora in the male fetus. They subsequently designed an operation (now called 'anatomical RP') that would spare these nerves, which were located in the neurovascular bundle next to the postero-lateral aspect of the prostate. 2 In this paper he also reported a small series of patients he had treated by this new method of RP and reported postoperative potency rates. Although the postoperative potency rate were far from perfect, these res...

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Section: Pt3b (Seminal Vesicle Invasion)mentioning

confidence: 99%

Radical prostatectomy for carcinoma of the prostate

et al. 2004

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“…Direct extension of the tumor through the capsule was associated with a significantly higher risk of lymph node metastasis. In contrast, the presence of isolated regions of cancer in the seminal vesicle with no contiguous primary cancer in the prostate was associated with a progression-free survival rate similar to that of 83 patients with extracapsular extension without SVI (5). This variation in SVI and the associated progression of the cancer suggests that more investigation is needed to understand the mechanism of prostate tumor cell invasion, with the long term goal of interrupting the process.…”

Section: Introductionmentioning

confidence: 90%

A human xenograft model for testing early events of epithelial neoplastic invasion

et al. 1997

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We report on a model of human prostate tumor cell invasion using the SCID (severe combined immunodeficient) mouse diaphragm. Tumor cells were injected into SCID mice intraperitoneally and the diaphragms harvested three to five weeks later. Electron microscopy showed tumor cell penetration of the mesothelial cell layer and adhesion to the underlying basement membrane on the inferior surface of the mouse diaphragm, where colonies developed. Immunohistochemistry showed invasion by tumor cells through the basement membrane into the muscle of the diaphragm, presence of human tumor cells among the muscle cells and the presence of selected proteins on the invasion front of the tumor cells. Digital image analysis enabled quantitative comparison of events in the metastatic cascade by variants of the tumor cell line and evaluation of the effectiveness of a putative tumor inhibitor. Results suggest that the SCID mouse diaphragm model is a convenient, effective, easily oriented and reproducible in vivo model of the early events associated with human prostate tumor cell invasion.

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“…Seminal vesicle invasion is defined by some groups as tumor infiltration of the muscular wall (Figure 1a), 28 whereas other older definitions have included invasion of the periseminal vesicle adipose tissue ( Figure 1b); 29 thus, different series assess differing microscopic criteria. Furthermore, many studies do not specify which assessment method was used, and hence these data are difficult to analyze.…”

Section: Seminal Vesicle Microscopic Assessmentmentioning

confidence: 99%

“…30 Prostatic carcinoma can invade the extraprostatic seminal vesicles by spreading along the ejaculatory duct (type 1), by direct invasion at the base of the prostate or by extending into peri-seminal vesicle soft tissue and then into the wall of the seminal vesicle (type 2) or, rarely, via discontinuous metastases (type 3). 28,31 Although these routes of infiltration are classified separately, it has been noted that types 1 and 2 invasion frequently occur together. The distinction of the main types of extraprostatic seminal vesicle invasion and their prognostic significance also has a scanty literature.…”

Section: Seminal Vesicle Microscopic Assessmentmentioning

confidence: 99%

International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 4: seminal vesicles and lymph nodes

et al. 2011

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The 2009 International Society of Urological Pathology Consensus Conference in Boston made recommendations regarding the standardization of pathology reporting of radical prostatectomy specimens. Issues relating to the infiltration of tumor into the seminal vesicles and regional lymph nodes were coordinated by working group 4. There was a consensus that complete blocking of the seminal vesicles was not necessary, although sampling of the junction of the seminal vesicles and prostate was mandatory. There was consensus that sampling of the vas deferens margins was not obligatory. There was also consensus that muscular wall invasion of the extraprostatic seminal vesicle only should be regarded as seminal vesicle invasion. Categorization into types of seminal vesicle spread was agreed by consensus to be not necessary. For examination of lymph nodes, there was consensus that special techniques such as frozen sectioning were of use only in high-risk cases. There was no consensus on the optimal sampling method for pelvic lymph node dissection specimens, although there was consensus that all lymph nodes should be completely blocked as a minimum. There was also a consensus that a count of the number of lymph nodes harvested should be attempted. In view of recent evidence, there was consensus that the diameter of the largest lymph node metastasis should be measured. These consensus decisions will hopefully clarify the difficult areas of

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The Mechanisms and Prognostic Significance of Seminal Vesicle Involvement by Prostate Cancer

Cited by 199 publications

References 0 publications

Radical prostatectomy for carcinoma of the prostate

Radical prostatectomy for carcinoma of the prostate

A human xenograft model for testing early events of epithelial neoplastic invasion

International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 4: seminal vesicles and lymph nodes

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