title: Oncologic outcomes after minimally invasive radical prostatectomy in patients with seminal vesicle invasion (pT3b) without adjuvant therapy.
abstract: OBJECTIVE
  To evaluate the long-term outcomes of patients with prostate cancer who have pathological pT3b N0-Nx, with postoperative PSA < 0.1 ng/ml and no systematic adjuvant treatment.
  
  
  METHODS
  Using a monocentric prospectively maintained database, we identified among 2,142 men who underwent minimally invasive radical prostatectomy, 104 pT3b N0-Nx patients, with postoperative PSA < 0.1 ng/ml and at least 5 years of follow-up. Patients were considered for salvage treatment at biochemical recurrence (PSA ≥ 0.2 ng/ml).
  
  
  RESULTS
  The median time of follow-up was 83.5 months (interquartile range [IQR]: 69-99). Overall, 102 patients (98 %) had T2 clinical stage or less. Specimen Gleason score was 7 in 71 patients (68 %) and <7 in 15 (14 %). Thirty-eight patients (37 %) were upgraded for Gleason score after radical prostatectomy. The overall 5-year probability of freedom from biochemical recurrence for the entire cohort was 55.8 % (95 % CI 45.8-65.8) and 73.3 % for patients who had specimen Gleason score <7 (p = 0.005). In univariate analysis, specimen Gleason score and surgical margin status were significant predictors for biochemical failure after radical prostatectomy (p = 0.05 and 0.007, respectively). In multivariate analysis, only specimen Gleason score >7 was significantly associated with biochemical failure (p = 0.009).
  
  
  CONCLUSIONS
  SVI is an adverse prognostic factor, but it is not associated with a uniformly poor prognosis. Specimen Gleason score and surgical margin status are significant predictors of recurrence after radical prostatectomy in patients with prostate cancer and SVI.
authors.affiliation: Department of Urology, Montsouris Institute, 42 Boulevard Jourdan, 75014, Paris, France.
authors.forename: Aurélien
authors.initials: A
authors.lastname: Forgues
authors.forename: François
authors.initials: F
authors.lastname: Rozet
authors.forename: François
authors.initials: F
authors.lastname: Audenet
authors.forename: Adil
authors.initials: A
authors.lastname: Ouzzane
authors.forename: Rafaël
authors.initials: R
authors.lastname: Sanchez-Salas
authors.forename: Eric
authors.initials: E
authors.lastname: Barret
authors.forename: Marc
authors.initials: M
authors.lastname: Galiano
authors.forename: Dominique
authors.initials: D
authors.lastname: Prapotnich
authors.forename: Xavier
authors.initials: X
authors.lastname: Cathelineau
mesh_terms: D000368:Aged; D015331:Cohort Studies; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D007610:Kallikreins / Q000097:blood; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000097:blood; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology / Q000601:surgery*; D012371:Robotics / Q000379:methods*; D012669:Seminal Vesicles / Q000473:pathology*
chemical_list: C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen