title: Lymphovascular invasion is an independent predictor of prostate-specific antigen failure after radical prostatectomy in patients with pT3aN0 prostate cancer.
abstract: OBJECTIVE
  To investigate the association of lymphovascular invasion (LVI) in radical prostatectomy (RP) specimens with prostate-specific antigen (PSA) failure in patients with pT3aN0 prostate cancer (PCA).
  
  
  METHODS
  We retrospectively reviewed the clinical records of 94 patients with pT3aN0 PCA treated with RP alone. All of the 94 patients were prospectively observed without any treatment until PSA failure was confirmed. We investigated the association of LVI with the adverse pathological findings in RP specimens and the PSA failure-free survival rate. The Cox proportional hazard model was used to elucidate predictors of PSA failure.
  
  
  RESULTS
  Median follow up was 47.4 months (quartile range 9.1 to 146.8). LVI was found in 26 (27.7%) of the 94 patients. In a multivariate analysis, PSA (P = 0.0054) and LVI (P = 0.015) were significant and independent predictors of PSA failure. Stratifying patients into four risk groups by LVI status and PSA level, the PSA failure-free survival rate in patients with negative LVI and PSA < or =10 ng/mL was significantly better than any other groups (positive LVI and/or PSA >10 ng/mL).
  
  
  CONCLUSIONS
  Adjuvant therapy would not be indicated to patients with pT3aN0 PCA with negative LVI and PSA < or =10 ng/mL.
authors: Department of Urology, Japanese Foundation for Cancer Research, Cancer Institute Hospital, Tokyo, Japan. yamamoto@jfcr.or.jp
authors: Shinya
authors: S
authors: Yamamoto
authors: Satoru
authors: S
authors: Kawakami
authors: Junji
authors: J
authors: Yonese
authors: Yasuhisa
authors: Y
authors: Fujii
authors: Yuhei
authors: Y
authors: Ohkubo
authors: Taisuke
authors: T
authors: Suyama
authors: Yoshinobu
authors: Y
authors: Komai
authors: Toshiki
authors: T
authors: Kijima
authors: Yuichi
authors: Y
authors: Ishikawa
authors: Iwao
authors: I
authors: Fukui
mesh_terms: D000368:Aged; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood* / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D017211:Treatment Failure; D019043:Vascular Neoplasms / Q000473:pathology
chemical_list: D017430:Prostate-Specific Antigen