The impact of lymphovascular invasion on long-term cancer outcomes following radical prostatectomy

You have accessJournal of UrologyCME1 Apr 2023MP67-01 THE IMPACT OF LYMPHOVASCULAR INVASION ON LONG-TERM CANCER OUTCOMES FOLLOWING RADICAL PROSTATECTOMY Niranjan Sathianathen, Marc Furrer, Clancy Mulholland, Nathan Lawrentschuk, and Niall Corcora Niranjan SathianathenNiranjan Sathianathen More articles by this author , Marc FurrerMarc Furrer More articles by this author , Clancy MulhollandClancy Mulholland More articles by this author , Nathan LawrentschukNathan Lawrentschuk More articles by this author , and Niall CorcoraNiall Corcora More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003330.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Lymphovascular invasion (LVI) has been shown to be associated with higher grade and stage of prostate cancer. However, the literature is scarce on its ability to predict long-term oncological outcomes. Therefore, we aim to evaluate the impact of LVI on long-term prostate cancer outcomes following radical prostatectomy. METHODS: A consecutive sample of patients with localised prostate cancer undergoing radical prostatectomy in a multicentre database was included in the analysis. Postoperative PSA measurements and clinical examinations were taken at 3, 6 and 12 months and afterwards yearly. Further diagnostic imaging was obtained with a rising PSA or clinical suspicion. Recurrence-free survival (RFS) and metastases-free survival (MFS) were analysed as a time-to-event outcome using Kaplan-Meier analyses with log-rank tests. To assess the effect of LVI, we created multivariable Cox proportional hazards models adjusting for relevant clinical and demographic characteristics. Ethics committee approval was obtained. RESULTS: A total of 3,732 men were included for analysis with a median follow-up of 44 months. LVI was detected in 18% (n=682). LVI was more common with increasing ISUP grade [RR 4.2, 95%CI 3.8-4.6] and pathological stage [RR 6.5, 95%CI 5.9-7.2]. The incidence of metastasis at 5-years was 12%. Men that were LVI+were more likely to develop metastatic disease than those that were LVI- (39% vs 6%, p<0.01). LVI was an independent predictor of metastasis [HR 2.2, 95%CI 1.7-3.0] and biochemical recurrence [HR 2.1, 95%CI 1.8-2.5]. This finding was consistently noted on subgroup analysis of men with both intermediate- and high-risk prostate cancer. CONCLUSIONS: Lymphovascular invasion is a prognostic indicator of adverse recurrence- and metastasis-free survival following surgery for prostate cancer. This can assist with risk-stratification following radical treatment and possibly aid decision-making regarding adjuvant treatment. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e943 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Niranjan Sathianathen More articles by this author Marc Furrer More articles by this author Clancy Mulholland More articles by this author Nathan Lawrentschuk More articles by this author Niall Corcora More articles by this author Expand All Advertisement PDF downloadLoading ...