MICROVASCULAR INVASION IN PROSTATE-CANCER CORRELATES WITH PATHOLOGICAL STAGE

Objective.-To determine the incidence of microvascular invasion in pro static carcinoma and its correlation with other prognostic factors. De sign.-Evaluation of the frequency and extent of microvascular invasion by routine light microscopy in 210 whole-mounted radical prostatectom ies with cancer. Results.-Microvascular invasion was identified in 111 (53%) of 210 specimens. Focal microvascular invasion (involvement of fewer than three high-power fields) was present in 42 cases (20%); ext ensive microvascular invasion (involvement of three or more high-power fields) was present in 69 cases (33%). Capsular perforation was prese nt in 43% and 62% of cases with focal and extensive microvascular inva sion, respectively. Seminal vesical involvement was observed in 23% an d 47% of cases with focal and extensive microvascular invasion, respec tively. Lymph node metastases were only observed in cases with microva scular invasion and were present in 7% and 23% of cases with focal and extensive invasion, respectively. There was also a strong positive co rrelation of microvascular invasion with surgical margin status, Gleas on score, and cancer volume. Tumors ranged in volume from 0.14 cc to 4 7.25 cc (mean, 9.09 CC), and the volume in cases without microvascular invasion was lower than in those with invasion (mean, 5.4 cc and 12.7 cc, respectively); also, the volume in cases with focal invasion was lower than in those with extensive invasion (mean, 9.4 cc and 16.1 cc, respectively). Conclusions.-Microvascular invasion in prostatic carci noma correlates positively with virtually all measures of pathologic s tage. Its presence should be reported in all prostate specimens accord ing to the Cancer Committee of the College of Americans Pathologists.