A contemporary analysis of outcomes of XXXX with seminal vesicle invasion (pT3b) after radical prostatectomy.

@entity1 @entity263 @entity5 @entity3 @entity1486
PURPOSE: Despite earlier detection and stage migration, seminal vesicle invasion is still reported in the @entity1486 era and remains a poor prognostic indicator. We investigated outcomes in @entity1 with pT3b disease in the contemporary era. MATERIALS AND METHODS: The institutional radical prostatectomy database (1982 to 2010) of 18,505 @entity1 was queried and 989 with pT3b @entity5 were identified. The cohort was split into pre- @entity1486 (1982 to 1992), and early (1993 to 2000) and contemporary (2001 to present) @entity1486 eras. Of the 732 @entity1 identified in the @entity1486 era 140 had lymph node involvement and were excluded from study. The Kaplan-Meier method was used to determine biochemical recurrence-free, @entity3 -free and @entity263 specific survival. Proportional hazard models were used to determine predictors of biochemical recurrence-free, @entity3 -free and @entity5 specific survival. RESULTS: In the pre- @entity1486 , and early and contemporary @entity1486 eras, 7.7%, 4.3% and 3.3% of @entity1 , respectively, had pT3bN0 disease (p >0.001). In pT3bN0 cases, the 10-year biochemical recurrence-free survival rate was 25.8%, 28.6% and 19.6% (p = 0.8), and the @entity5 specific survival rate was 79.9%, 79.6% and 83.8% (p = 0.6) among the eras, respectively. In pT3bN0 cases in the @entity1486 era, @entity1486 , clinical stage T2b or greater, pathological Gleason sum 7 and 8-10, and positive surgical margins were significant predictors of biochemical recurrence-free survival on multivariate analysis while clinical stage T2c or greater and Gleason 8-10 were predictors of @entity3 -free and @entity5 specific survival. CONCLUSIONS: Despite a decreased frequency of pT3b disease, and lower rates of positive surgical margins and lymph nodes, @entity1 with seminal vesicle invasion continue to have low biochemical recurrence-free survival. Advanced clinical stage, intermediate or high risk Gleason sum at pathological evaluation and positive surgical margins predict biochemical recurrence. High risk clinical stage and Gleason sum predict @entity3 -free and @entity5 specific survival.
