SVI, LNI Have Similar Effect on Prostate Cancer Survival
SAN DIEGO—Seminal vesical invasion (SVI) and lymph node invasion (LNI) have a similar effect on cancer-specific survival in patients undergoing radical prostatectomy for prostate cancer, researchers reported at the American Urological Association annual meeting.
Manuel S. Eisenberg, MD, and colleagues at Mayo Clinic in Rochester, Minn., identified 15,833 patients who underwent radical prostatectomy (RP) without neoadjuvant therapy and stratified them according to the presence or absence of SVI and the presence or absence of LNI. The median follow-up after surgery was 9.5 years, during which 470 patients died from prostate cancer. A total of 422 patients with SVI had concurrent LNI.
The 15-year cancer-specific survival (CSS) among patients without SVI or LNI was 97% compared with 88% among patients with LNI but not SVI, Dr. Eisenberg's team reported. The 15-year CSS for patients with SVI but not LNI was nearly identical (84%) to that of patients with LNI but not SVI, but decreased to 77% in patients who had both SVI and LNI.
In multivariate analysis, LNI was significantly associated with cancer-related death regardless of SVI status. This association was more than two times greater among patients without SVI than among patients with SVI.
Although LNI has a significant impact on survival among patients with and without SVI, “the relative strength of LNI has a prognostic feature is markedly diminished in the setting of locally advanced tumor stage,” the authors concluded. “These data support the importance of achieving maximal local tumor control during RP for high-risk prostate cancer, regardless of LNI.”