Combining lymphovascular invasion with reactive stromal grade predicts prostate cancer mortality.
Previous studies suggest that lymphovascular invasion (LVI) has a weak and variable effect on prognosis. It is uncertain whether LVI, determined by diagnostic prostate biopsy, predicts prostate cancer death. Data from experimental studies have indicated that carcinoma-associated fibroblasts in the reactive stroma could promote LVI and progression to metastasis. Thus, combining LVI with reactive stromal grade may identify prostate cancer patients at high risk of an unfavorable outcome. The purpose of the present study was to examine if LVI, determined by diagnostic biopsy, alone and in combination with reactive stromal grade could predict prostate cancer death.



This population-based study included 283 patients with prostate cancer diagnosed by needle biopsy in Aust-Agder County (Norway) from 1991 to 1999. Clinical data were obtained by medical charts review. Two uropathologists evaluated LVI and reactive stromal grade. The endpoint was prostate cancer death.



Patients with LVI had marginally higher risk of prostate cancer death compared to patients without LVI (hazard ratio: 1.8, P-value = 0.04). LVI had a stronger effect on prostate cancer death risk when a high reactive stromal grade was present (hazard ratio: 16.0, P-value <0.001). Therefore, patients with concomitant LVI and high reactive stromal grade were at particularly high risk for prostate cancer death.



Evaluating LVI together with reactive stromal grade on diagnostic biopsies could be used to identify patients at high risk of death from prostate cancer. Prostate 76:1088-1094, 2016. © 2016 Wiley Periodicals, Inc.
Medical Faculty, University of Oslo, Oslo, Norway.|Department of Surgery, Sørlandet Hospital Arendal, Arendal, Norway.
Thorstein
T
Saeter
Department of Pathology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.
Ljiljana
L
Vlatkovic
Department of Surgery, Sørlandet Hospital Arendal, Arendal, Norway.
Gudmund
G
Waaler
Department of Surgery, Sørlandet Hospital Arendal, Arendal, Norway.
Einar
E
Servoll
Medical Faculty, University of Oslo, Oslo, Norway.|Department of Pathology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.
Jahn M
JM
Nesland
Department of Urology, Akershus University Hospital, Lørenskog, Norway.
Karol
K
Axcrona
Department of Pathology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.
Ulrika
U
Axcrona
D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D005347:Fibroblasts / Q000473:pathology; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009367:Neoplasm Staging; D011379:Prognosis; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D012307:Risk Factors; D017154:Stromal Cells / Q000473:pathology
D017430:Prostate-Specific Antigen
lymphovascular invasion; prognosis; prostate cancer; reactive stroma