title: Microvascular invasion is an independent prognostic factor in patients with prostate cancer treated with radical prostatectomy.
abstract: OBJECTIVE
  Current published data regarding the prognostic value of microvascular invasion (MVI) in patients with prostate cancer (PCa) have yielded mixed results. Furthermore, most important series had surgical procedures performed by multiple surgeons and surgical specimens analyzed by multiple pathologists. We determined the relation of MVI with other pathologic features and whether this finding can be used as an independent prognostic factor in patients with PCa.
  
  
  METHODS
  We selected 428 patients with clinically localized PCa treated with radical prostatectomy (RP). MVI was correlated to other pathologic features. The Kaplan-Meier method was used to evaluate survival curves and statistical significance was determined by the log-rank test. Multivariate analysis was performed through a Cox proportional hazards regression model.
  
  
  RESULTS
  Eleven percent out of the 428 patients presented MVI. Except for the lack of association with biopsy Gleason score, MVI was related to all clinical and pathologic features of RP specimens. Mean follow up after surgery was 53.9 +/- 20.1 months. Patients with MVI presented a recurrence rate of 44.6% compared to only 20.2% for patients without MVI (Log-rank test - p < 0.001). After Cox regression analysis, MVI was an independent prognostic feature related to biochemical recurrence.
  
  
  CONCLUSIONS
  MVI is associated to advanced pathologic features of PCa and is an important prognostic factor regarding disease recurrence in patients treated with RP. These findings support the recommendations to the routine evaluation of this variable in pathologic reports of RP specimens.
authors.affiliation: Division of Urology, University of Sao Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Alberto A
authors.initials: AA
authors.lastname: Antunes
authors.forename: Miguel
authors.initials: M
authors.lastname: Srougi
authors.forename: Marcos F
authors.initials: MF
authors.lastname: Dall'Oglio
authors.forename: Alexandre
authors.initials: A
authors.lastname: Crippa
authors.forename: Mario
authors.initials: M
authors.lastname: Paranhos
authors.forename: Jose
authors.initials: J
authors.lastname: Cury
authors.forename: Luciano J
authors.initials: LJ
authors.lastname: Nesrallah
authors.forename: Katia R
authors.initials: KR
authors.lastname: Leite
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D001938:Brazil / Q000453:epidemiology; D002277:Carcinoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D018450:Disease Progression; D018572:Disease-Free Survival; D004812:Epidemiologic Methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery
chemical_list: D017430:Prostate-Specific Antigen