Adenocarcinoma of the prostate invading the seminal vesicle: prognostic stratification based on pathologic parameters

Epstein, Jonathan I; Partin, Alan W; Potter, Steven R; Walsh, Patrick C

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Volume 56, Issue 2 , Pages 283-288, August 2000

Adenocarcinoma of the prostate invading the seminal vesicle: prognostic stratification based on pathologic parameters☆

Jonathan I Epstein
- Department of Pathology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
- James Buchanan Brady Urological Institute, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
- Reprint requests: Jonathan I. Epstein, M.D., Department of Pathology, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287
Alan W Partin
- Department of Urology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
- James Buchanan Brady Urological Institute, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
Steven R Potter
- James Buchanan Brady Urological Institute, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
Patrick C Walsh
- Department of Urology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
- James Buchanan Brady Urological Institute, Johns Hopkins Medical Institution, Baltimore, Maryland, USA

Received 25 October 1999; received in revised form 3 April 2000; accepted 3 April 2000.

Abstract

Objectives. To stratify the prognosis of lymph node-negative, seminal vesicle-positive tumors in men with prostate cancer after radical retropubic prostatectomy.

Methods. Sixty cases were analyzed for multiple parameters and correlated with postoperative biochemical (prostate-specific antigen) progression. Variables included Gleason score, primary Gleason pattern, percentage of Gleason pattern 4, any presence of Gleason pattern 5, method of seminal vesicle invasion (SVI), margin positivity, SVI extent, SVI bilaterality, vascular invasion, extent of extraprostatic extension, length of tumor extending along the seminal vesicles, presence of intraductal carcinoma within the prostate, bladder neck margin positivity, and tumor volume.

Results. We were able to stratify the prognosis based on the combination of a variation of the Gleason score and margin status and vascular invasion status. Using this stratification, a few patients had an excellent long-term prognosis, with most patients split into two groups, one experiencing rapid and the other slower progression.

Conclusions. SVI is not associated with a uniformly poor prognosis. Rather, tumors can be substratified by pathologic parameters into groups with differing prognoses based on routine histologic examination.