Clinicopathological Significance of the Lymphovascular Invasion Detected in Specimens from Radical Retropubic Prostatectomies

Myung Cheol Gil; In Ho Chang; Yong Jun Kim; Jin Kyu Oh; Sung Kyu Hong; Seok Soo Byun; Sang Eun Lee

doi:10.4111/kju.2006.47.7.757

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Gil, Chang, Kim, Oh, Hong, Byun, and Lee: Clinicopathological Significance of the Lymphovascular Invasion Detected in Specimens from Radical Retropubic Prostatectomies

Original Article

Korean J Urol 2006;47(7):757-761.

Published online: 18 December 2006

DOI: https://doi.org/10.4111/kju.2006.47.7.757

Clinicopathological Significance of the Lymphovascular Invasion Detected in Specimens from Radical Retropubic Prostatectomies

Myung Cheol Gil, In Ho Chang, Yong Jun Kim, Jin Kyu Oh, Sung Kyu Hong, Seok Soo Byun, Sang Eun Lee

¹From the Department of Urology Seoul National University Bundang Hospital, Seongnam, Korea

Corresponding Author: Lee Sang-eun Department of Urology, Seoul National University Bundang Hospital Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 300 street ? 705-034 TEL: 031-787-7349 FAX: 031-787-4057 E-mail: selee@snubh.org

Received 5 December 2005 Accepted 7 June 2006

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose:

We tried to determine the clinicopathological significance of lymphovascular invasion (ᄂVI) in patients who were treated for prostate cancer with radical retropubic prostatectomy.

Materials and Methods:

From November 2003 to June 2005, 165 patients underwent radical retropubic prostatectomy for clinically-localized prostate cancer at our institution. The results of the final pathologic analyses were reviewed.

Results:

Of the 165 total patients, foci of LVI were identified in 46 patients. LVI was associated with a higher preoperative serum level of prostate- specific antigen (p=0.006), the Gleason score (p く 0.0001), a higher weight of tumor volume (p く 0.0001), a higher rate of capsular penetration (p く 0.0001), a higher rate of seminal vesicle involvement (p く 0.0001), and a higher rate of a positive margin (p く 0.0001).

Conclusions:

Since the pathological features of LVI appear to be associated with the other established features of more advanced prostate cancers, they may prove to be useful markers for predicting the prognosis of patients who undergo radical prostatectomy. Our findings support performing routine evaluation for LVI in radical prostatectomy specimens and its inclusion in the models for predicting the clinical outcome. (Korean J Urol 2006;47:757-761)

Keywords: Prostate cancer, Lymphovascular invasion, Prostatectomy

REFERENCES

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Fig. 1.

Pathologic findings of lymphovascular invasion in a prostate cancer specimen (H&E, x400).

Table 1.

Clinical characteristics of the 165 patients

Variable
Mean age (years)	65.0±6.0
Mean PSA (ng/ml)	11.6± 12(0.2-63.2)
Mean prostate volume (ml)	26.3±8.1 (7-79)
No. of biopsy cores	13.4±1.7
Transrectal ultrasound guided biopsy Gleason score	6.7±0.8

PSA: prostate-specific antigen

Table 2.

Association of LVI with the various pathological parameters

	LVI(+)	LVI(-)	p-value
No. of patients (%)	46 (27.9)	119(72.1)
Mean age (years)	64.5+6.3	64.6±6.4	0.125
Mean PSA (ng/ml)	17.5+14.1	9.3±10.2	0.006
Abnormal DRE (%)	17 (36.9)	27 (22.7)	0.24
Preoperative Gleason sum	7.3±0.9	6.5±0.7	<0.0001
Postoperative Gleason sum	7.3±0.8	6.7±0.6	<0.0001
Mean prostatic cancer weight (gm)	12.3±9.9	4.9±5.5	<0.0001
Capsular penetration (%)	24 (50)	12 (10.1)	<0.0001
Seminal vesicle invasion (%)	13(27.1)	4 (3.4)	<0.0001
Positive margin (%)	16 (33.3)	3 (2.5)	< 0.0001
No. of pathologic state (%)			< 0.0001
T2	22 (46.8)	106 (89.1)
T3	25 (52.1)	12 (10.1)

LVI: lymphovascular invasion, PSA: prostate-specific antigen, DRE: digital rectal examination

Table 3.

Association of LVI with the various immunohistochemical parameters

	LVI(+)	LVI(-)	p-value
bcl-2 (%)	3/30 (10)	14/86 (16.3)	0.402
p53 (%)	2/41 (4.9)	4/107 (3.7)	0.753
Ki-67 (%)	12/34 (35.3)	18/92 (19.6)	0.066

LVI: lymphovascular invasion

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