PROGNOSTIC-SIGNIFICANCE OF SEMINAL-VESICLE INVASION ON THE RADICAL PROSTATECTOMY SPECIMEN - RATIONALE FOR SEMINAL-VESICLE BIOPSIES

Objective: The prognostic significance of seminal vesicle invasion on the radical prostatectomy specimen was evaluated according to the prox imal or distal site of this invasion. Materials and Methods: 52 consec utive patients undergoing radical prostatectomy for stage pT3b N0 M0 p rostatic cancer were classified into two groups: group A(18 patients): patients with invasion limited to the proximal part of the seminal ve sicles (stage T3b limited); group B (34 patients): patients with invas ion extending to the free part of the seminal vesicles (stage T3b exte nsive). The PSA progression-free curves were compared between the two groups. A multivariable regression model was performed to determine in dependent prognostic factors. Results: Overall, the 5-year PSA progres sion free rate of the 52 patients was 14.4%. The 5-year PSA progressio n-free rate of the patients in group A was 45.4 vs. 4.2% at 4 years in group B (p = 0.0004). The stage of seminal vesicle invasion and the G leason score were the only independent predictive factors of PSA progr ession (p = 0.02 and p = 0.04, respectively). Conclusions: The prognos tic significance of seminal vesicle invasion is not constant and depen ds on the site of invasion. Preoperative seminal vesicles biopsies can select patients with invasion extending to the free part of seminal v esicles and who have a poor prognosis in terms of PSA progression afte r radical prostatectomy.