Evaluation of lymphovascular invasion as a prognostic predictor of overall survival after radical prostatectomy
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Evaluation of lymphovascular invasion as a prognostic predictor of overall survival after radical prostatectomy. / Rakic, Nikola; Jamil, Marcus; Keeley, Jacob; Sood, Akshay; Vetterlein, Malte; Dalela, Deepansh; Arora, Sohrab; Modonutti, Daniele; Bronkema, Chandler; Novara, Giacomo; Peabody, James; Rogers, Craig; Menon, Mani; Abdollah, Firas.
In: UROL ONCOL-SEMIN ORI, Vol. 39, No. 8, 08.2021, p. 495.e1-495.e6.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Evaluation of lymphovascular invasion as a prognostic predictor of overall survival after radical prostatectomy
AU - Rakic, Nikola
AU - Jamil, Marcus
AU - Keeley, Jacob
AU - Sood, Akshay
AU - Vetterlein, Malte
AU - Dalela, Deepansh
AU - Arora, Sohrab
AU - Modonutti, Daniele
AU - Bronkema, Chandler
AU - Novara, Giacomo
AU - Peabody, James
AU - Rogers, Craig
AU - Menon, Mani
AU - Abdollah, Firas
N1 - Copyright © 2021. Published by Elsevier Inc.
PY - 2021/8
Y1 - 2021/8
N2 - OBJECTIVE: To assess the prognostic ability of lymphovascular invasion (LVI) as a predictor of overall survival (OS).MATERIALS AND METHODS: We included 126,682 prostate cancer (CaP) cM0 patients who underwent radical prostatectomy with lymph node dissection between 2010 and 2015, within the National Cancer Database. Patients who received androgen deprivation therapy were included. Patients were divided into four sub-cohorts based on LVI and lymph node invasion (LNI) status: pL0N0, pL1N0, pL0N1, and pL1N1. Kaplan-Meier curves estimated OS and Cox-regression analysis tested the relationship between LVI and OS.RESULTS: Median (IQR) age and PSA at diagnosis were 62 (57-66) years and 5.7 (4.5-8.9) ng/ml, respectively. Most patients had pT2 stage (68.5%), and pathological Gleason 3+4 (46.7%). 10.0% and 4.0% patients had LVI and LNI, respectively. Median follow-up was 42 months (27-58). At 5-years, OS was 96.5% in pL0N0 patients vs 93.1% pL1N0 patients vs 93.3% in pL0N1 patients vs 86.6% pL1N1 patients. LVI was an independent predictor of OS (hazard ratio [HR]:1.28). LVI showed interaction with LNI, as LVI was associated with a higher overall-mortality in patients with LNI (HR:1.66), than in patients without LNI (HR:1.22). (all P<0.0001) CONCLUSIONS: Our report highlights the detrimental impact of LVI on OS. Patients with LVI alone fared similarly to patients with LNI alone. Patients with both LVI and LNI had worse OS than those with only LVI or LNI, implying a synergetic detrimental interaction. Our findings demonstrate an important utility that LVI can provide in deciding patients' prognoses.
AB - OBJECTIVE: To assess the prognostic ability of lymphovascular invasion (LVI) as a predictor of overall survival (OS).MATERIALS AND METHODS: We included 126,682 prostate cancer (CaP) cM0 patients who underwent radical prostatectomy with lymph node dissection between 2010 and 2015, within the National Cancer Database. Patients who received androgen deprivation therapy were included. Patients were divided into four sub-cohorts based on LVI and lymph node invasion (LNI) status: pL0N0, pL1N0, pL0N1, and pL1N1. Kaplan-Meier curves estimated OS and Cox-regression analysis tested the relationship between LVI and OS.RESULTS: Median (IQR) age and PSA at diagnosis were 62 (57-66) years and 5.7 (4.5-8.9) ng/ml, respectively. Most patients had pT2 stage (68.5%), and pathological Gleason 3+4 (46.7%). 10.0% and 4.0% patients had LVI and LNI, respectively. Median follow-up was 42 months (27-58). At 5-years, OS was 96.5% in pL0N0 patients vs 93.1% pL1N0 patients vs 93.3% in pL0N1 patients vs 86.6% pL1N1 patients. LVI was an independent predictor of OS (hazard ratio [HR]:1.28). LVI showed interaction with LNI, as LVI was associated with a higher overall-mortality in patients with LNI (HR:1.66), than in patients without LNI (HR:1.22). (all P<0.0001) CONCLUSIONS: Our report highlights the detrimental impact of LVI on OS. Patients with LVI alone fared similarly to patients with LNI alone. Patients with both LVI and LNI had worse OS than those with only LVI or LNI, implying a synergetic detrimental interaction. Our findings demonstrate an important utility that LVI can provide in deciding patients' prognoses.
U2 - 10.1016/j.urolonc.2021.01.007
DO - 10.1016/j.urolonc.2021.01.007
M3 - SCORING: Journal article
C2 - 33602620
VL - 39
SP - 495.e1-495.e6
JO - UROL ONCOL-SEMIN ORI
JF - UROL ONCOL-SEMIN ORI
SN - 1078-1439
IS - 8
ER -