ПРОГНОСТИЧЕСКОЕ ЗНАЧЕНИЕ ПЕРИНЕВРАЛЬНОЙ И АНГИОЛИМФАТИЧЕСКОЙ ИНВАЗИИ У БОЛЬНЫХ РАКОМ ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫ PT1-4N0-1M0, ПОДВЕРГНУТЫХ РАДИКАЛЬНОЙ ПРОСТАТЭКТОМИИ
https://doi.org/10.17650/1726-9776-2010-6-1-33-38
Аннотация
Objective: to evaluate the prognostic value of microvascular and perineural invasion on radical prostatectomy specimens in prostate cancer patients. Subjects: 144 patients with prostate cancer pT1-4N0-1M0 underwent radical prostatectomy at the Cancer Center in 1997 to 2008. The median age was 60.06.4 (43-73) years. The median preoperative PSA level was 10.413.7 (0.8-95.7) ng/ml (PSA<10 ng/ml; n = 67 (46.5%), PSA ≥10 ng/ml; n = 77 (53.5%). Histological study verified adenocarcinoma in all specimens. The median Gleason score was 6.01.4 (Gleason score <7; n = 112 (77.8%), Gleason score ≥7; n = 32 (22.2%)). Extracapsular tumor extension was revealed in 47 (32.6%), seminal vesicle invasion in 13 (9.0%), regional lymph node metastases in 9 (6.3%), positive margin in 9 (6.3%), microvascular invasion in 58 (40.3%), perineural invasion in 61 (42.4%) of the 144 cases. The median follow-up was 36.615.2 months. Results: microvascular invasion was associated with an increase of Gleason score≥7 rate from 15.1 to 32.8% (p=0.015), extracapsular extension rate from 17.4 to 55.2% (p<0.0001), seminal vesicle invasion rate from 1.2 to 20.7% (p<0.0001) and category N+ rate from 3.5 to 10.3% (p=0.095). Perineural invasion was associated with an increase of extracapsular extension rate from 19.3 to 50.8% (p<0.0001) and seminal vesicle invasion rate from 0.0 to 21.3% (p<0.0001). Microvascular and perineural invasion did not influence positive margin rate (p>0.05). Prostate cancer recurrence developed in 19 (13.2%) of the 144 patients. Relapses were registered more frequently in patients with microvascular (from 8.1 to 20.7% respectively, p=0.028) and perineural (from 8.4 to 19.7% respectively; p=0.043) invasion. Five-year overall, specific and PSA recurrence-free survival in a group of 144 patients was 97.6, 98.3, and 82.1%, respectively. Microvascular invasion significantly decreased 5-year PSA recurrence-free survival from 90.0 to 66.8% (p=0.050), but this difference did not translate into a statistically significant reduction in overall (98.8 and 96.0%, respectively, p=0.812) and specific (100.0 and 96.0% respectively, p=0.251) survival. Perineural invasion was associated with a significant decrease in 5-year PSA recurrence-free survival from 92.4 to 68.2% (p=0.045). Overall (100.0% and 94.1% respectively, p=0.090) and specific (100.0% and 95.7% respectively, p=0.217) survival differences between the groups without and with perineural invasion did not reach statistical significance. Conclusion: microvascular and perineural invasion is associated with the worst pathological findings in prostatectomy specimens, higher recurrence rate and lower PSA recurrence-free survival in patients with prostate cancer pT1-4N0-1M0.
Об авторах
В. Б. Матвеев
ГУ РОНЦ им. Н.Н. Блохина РАМН, Москва
Россия
Россия
М. И. Волкова
ГУ РОНЦ им. Н.Н. Блохина РАМН, Москва
Россия
Россия
А. А. Митин
ГУ РОНЦ им. Н.Н. Блохина РАМН, Москва
Россия
Россия
В. Д. Ермилова
ГУ РОНЦ им. Н.Н. Блохина РАМН, Москва
Россия
Россия
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Рецензия
Для цитирования:
Матвеев В.Б., Волкова М.И., Митин А.А., Ермилова В.Д. ПРОГНОСТИЧЕСКОЕ ЗНАЧЕНИЕ ПЕРИНЕВРАЛЬНОЙ И АНГИОЛИМФАТИЧЕСКОЙ ИНВАЗИИ У БОЛЬНЫХ РАКОМ ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫ PT1-4N0-1M0, ПОДВЕРГНУТЫХ РАДИКАЛЬНОЙ ПРОСТАТЭКТОМИИ. Онкоурология. 2010;6(1):33-38. https://doi.org/10.17650/1726-9776-2010-6-1-33-38
For citation:
Matveev V.B., Volkova M.I., Mitin A.A., Ermilova V.D. PROGNOSTIC VALUE OF MICROVASCULAR AND PERINEURAL INVASION IN PATIENTS WITH PROSTATE CANCER PT1-4N0-1M0 WHO UNDERWENT RADICAL PROSTATECTOMY. Cancer Urology. 2010;6(1):33-38. (In Russ.) https://doi.org/10.17650/1726-9776-2010-6-1-33-38
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