Adenocarcinoma of the prostate invading the seminal vesicle: prognostic stratification based on pathologic parameters.
OBJECTIVE
To stratify the prognosis of lymph node-negative, seminal vesicle-positive tumors in men with prostate cancer after radical retropubic prostatectomy.


METHODS
Sixty cases were analyzed for multiple parameters and correlated with postoperative biochemical (prostate-specific antigen) progression. Variables included Gleason score, primary Gleason pattern, percentage of Gleason pattern 4, any presence of Gleason pattern 5, method of seminal vesicle invasion (SVI), margin positivity, SVI extent, SVI bilaterality, vascular invasion, extent of extraprostatic extension, length of tumor extending along the seminal vesicles, presence of intraductal carcinoma within the prostate, bladder neck margin positivity, and tumor volume.


RESULTS
We were able to stratify the prognosis based on the combination of a variation of the Gleason score and margin status and vascular invasion status. Using this stratification, a few patients had an excellent long-term prognosis, with most patients split into two groups, one experiencing rapid and the other slower progression.


CONCLUSIONS
SVI is not associated with a uniformly poor prognosis. Rather, tumors can be substratified by pathologic parameters into groups with differing prognoses based on routine histologic examination.
Department of Pathology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA.
J I
JI
Epstein
A W
AW
Partin
S R
SR
Potter
P C
PC
Walsh
D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology*; D018450:Disease Progression; D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D012669:Seminal Vesicles / Q000473:pathology*; D016896:Treatment Outcome
D017430:Prostate-Specific Antigen