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International Journal of Clinical Oncology

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01-02-2020 | Prostate Cancer | Original Article

The significance of micro-lymphatic invasion and pathological Gleason score in prostate cancer patients with pathologically organ-confined disease and negative surgical margins after robot-assisted radical prostatectomy

Authors: Takeshi Hashimoto, Jun Nakashima, Rie Inoue, Osamu Komori, Yuri Yamaguchi, Takeshi Kashima, Naoya Satake, Yoshihiro Nakagami, Kazunori Namiki, Toshitaka Nagao, Yoshio Ohno

Published in: International Journal of Clinical Oncology | Issue 2/2020

Abstract

Background

The development process of recurrence in prostate cancer patients with pathologically organ-confined (pT2) disease and negative surgical margins is unclear. The aim of the present study was to determine factors associated with the development of biochemical recurrence following robot-assisted radical prostatectomy among those prostate cancer patients.

Methods

We retrospectively reviewed the data of patients who underwent robot-assisted radical prostatectomy without neoadjuvant endocrine therapy. We evaluated prognostic factors in 1096 prostate cancer patients with pT2 disease and negative surgical margins. Univariate and multivariate Cox proportional hazards regression analyses were used to identify independent predictors for biochemical recurrence.

Results

Of the 1096 patients, 55 experienced biochemical recurrence during the follow-up period. The 5-year biochemical recurrence-free survival rate for patients with pT2 and negative surgical margins was 91.8%. On univariate analysis, clinical stage, biopsy Gleason score, percent of positive core, pathological Gleason score, and the presence of micro-lymphatic invasion were significantly associated with biochemical recurrence. On a multivariate analysis, the presence of micro-lymphatic invasion and a pathological Gleason score ≥ 4 + 3 were significant prognostic factors for biochemical recurrence. Based on these factors, we developed a risk stratification model. The biochemical recurrence-free survival rate differed significantly among the risk groups.

Conclusions

The prognosis of prostate cancer patients with pT2 disease and negative surgical margins is favorable. However, patients with the presence of micro-lymphatic invasion and a pathological Gleason score ≥ 4 + 3 tend to experience biochemical recurrence more often after surgery. Therefore, careful follow-up might be necessary for those patients.

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Title: The significance of micro-lymphatic invasion and pathological Gleason score in prostate cancer patients with pathologically organ-confined disease and negative surgical margins after robot-assisted radical prostatectomy
Authors: Takeshi Hashimoto
Jun Nakashima
Rie Inoue
Osamu Komori
Yuri Yamaguchi
Takeshi Kashima
Naoya Satake
Yoshihiro Nakagami
Kazunori Namiki
Toshitaka Nagao
Yoshio Ohno
Publication date: 01-02-2020
Publisher: Springer Singapore
Keywords: Prostate Cancer
Prostate Cancer
Prostatectomy
Prostatectomy
Published in: International Journal of Clinical Oncology / Issue 2/2020
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-019-01561-4

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Abstract

Background

Methods

Results

Conclusions

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