[Current value of seminal vesicle biopsy in patients with prostate cancer and influence of radical prostatectomy in patients with seminal vesicle invasion].
OBJECTIVE
To evaluate if radical prostatectomy may positively influence cancer-specific survival (CSS), hormone-resistance-free time, metastasis-free time, and quality of life(QoL) of patients with prostate adenocarcinoma and seminal vesicle invasion, and also to update our thoughts about seminal vesicle biopsy.


METHODS
114 patients were included. Forty-six cases were diagnosed of seminal vesicle invasion after radical prostatectomy; 68 cases were diagnosed of seminal vesicle invasion after biopsy, not undergoing then surgery. Cancer specific survival, time to hormone resistance from the start of hormonal treatment, metastasis free time and QoL, measured as need for hospital care, were compared between groups. Median follow-up time was 52.6 mos.


RESULTS
There were not statistically significant differences between groups in CSS, time to hormone resistance, metastasis free time and QoL. Three and five-year cancer specific survival were 100% and 80.77% for the radical prostatectomy group and 74.4% and 56.2% for the biopsy group. Primary grade and Gleason Score were independent predictors for CSS in the Cox regression test; clinical stage was independent predictor for time to hormone resistance.


CONCLUSIONS
Radical prostatectomy as monotherapy does not show a statistically significant influence on followup time, CSS, time to hormone resistance, metastasis free time or QoL in patients with prostate cancer and seminal vesicle invasion associated with other bad prognostic factors (unfavourable Gleason and PSA). The value of seminal vesicle biopsy remains for the study of new multimodal treatments, such as chemotherapy + surgery, and it is to be defined in the planning of radio and cryosurgery.
Losa
Carlos Alberto Allepuz
CA
Servicio de Urología, Hospital Universitario Miguel Servet, Pso. Isabel la Católica, 1 y 3, 50009 Zaragoza, España. callepuz@salud.aragon.es
Fernando
Angel Borque
AB
Lázaro
Vicente Andrés
VA
Berlanga
Francesc Filipo
FF
Frago
Patricia Serrano
PS
López
Marta Allúe
MA
Sanz
María Jesús Gil
MJ
Martínez
Pedro Gil
PG
Sanz
Luis Angel Rioja
LA
D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery*; D000368:Aged; D001706:Biopsy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D012669:Seminal Vesicles / Q000473:pathology*