Prediction of biochemical recurrence after radical prostatectomy using peritumoral lymphatic vessel density in biopsy specimens in patients with localized prostate cancer.
BACKGROUND
Lymphatic invasion has been associated with biochemical recurrence (BCR), and many patients with postoperative elevation of prostate-specific antigen (PSA) develop distant metastases within several years. We previously found peritumoral lymphatic vessel density (PTLD) in biopsy cores to be an independent predictor of lymphatic invasion in radical prostatectomy specimens, so we speculate that PTLD parameters in biopsy specimens could also be independent predictors of BCR after surgery.


METHODS
We obtained positive biopsy cores from 110 patients who underwent radical prostatectomy at our institution. Biopsy cores were immunostained with the D2-40 monoclonal antibody, which specifically and selectively detects lymphatic endothelium. We evaluated differences between the BCR-free survival rates and used univariate and multivariate analyses to detect independent predictors of BCR.


RESULTS
The results of a Cox proportional hazards model showed that lymphatic invasion in prostatectomy specimens was one of the independent postoperative prognostic factors for BCR (p = 0.0338). An additional model showed that one PTLD parameter, maximal PTLD, was among the independent preoperative predictors of lower BCR-free survival rates (p = 0.0200).


CONCLUSIONS
Information about PTLD in prostate biopsy specimens could be helpful for selecting patients as radical prostatectomy candidates, and patients with high PTLD values should be carefully monitored after surgery.
Department of Urology, National Defense Medical College, Tokorozawa, Japan. kksmy @ sa2.so-net.ne.jp
Kenji
K
Kuroda
Akio
A
Horiguchi
Takako
T
Asano
Shinsuke
S
Tasaki
Hidehiko
H
Yoshii
Akinori
A
Sato
Junichi
J
Asakuma
Keiichi
K
Ito
Kenji
K
Seguchi
Makoto
M
Sumitomo
Tomohiko
T
Asano
D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived; D001706:Biopsy; D018572:Disease-Free Survival; D004729:Endothelium, Lymphatic / Q000276:immunology / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D007564:Japan; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D042601:Lymphatic Vessels / Q000276:immunology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy / Q000009:adverse effects / Q000401:mortality; D011471:Prostatic Neoplasms / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
D058846:Antibodies, Monoclonal, Murine-Derived; C500987:monoclonal antibody D2-40; D017430:Prostate-Specific Antigen