Details

Autor(en) / Beteiligte

• May, Matthias
• Brookman-May, Sabine
• Burger, Maximilian
• Gilfrich, Christian
• Fritsche, Hans-Martin
• Rink, Michael
• Chun, Felix
• Fisch, Margit
• Roghmann, Florian
• Noldus, Joachim
• Mayr, Roman
• Pycha, Armin
• Novotny, Vladimir
• Wirth, Manfred
• Vallo, Stefan
• Haferkamp, Axel
• Roigas, Jan
• Brisuda, Antonin
• Stredele, Regina
• Volkmer, Björn
• Dechet, Christopher
• Schnabel, Marco
• Denzinger, Stefan
• Stief, Christian G.
• Bastian, Patrick J.
• Aziz, Atiqullah

Titel

Concomitant Seminal Vesicle Invasion in pT4a Urothelial Carcinoma of the Bladder with Contiguous Prostatic Infiltration is an Adverse Prognosticator for Cancer-Specific Survival after Radical Cystectomy

Ist Teil von

• Annals of surgical oncology, 2014-11, Vol.21 (12), p.4034-4040

Ort / Verlag

Boston: Springer US

Erscheinungsjahr

2014

Link zum Volltext

Quelle

SpringerLink (Online service)

Beschreibungen/Notizen

• Purpose To evaluate the prognostic value of concomitant seminal vesicle invasion (cSVI) in patients with urothelial carcinoma of the bladder (UCB) and contiguous prostatic stromal infiltration in a large cystectomy series. Methods A total of 385 patients with UCB and contiguous prostatic infiltration comprised our study. Patients were divided in two groups according to cSVI. Median follow-up was 36 months (interquartile range 11–74); the primary end point was cancer-specific mortality. The prognostic impact of cSVI was evaluated using multivariable Cox regression analysis. The predictive accuracy was assessed by a receiver operating characteristic analysis. Results A total of 229 patients (59.5 %) without cSVI comprised group A, and 156 patients (40.5 %) with cSVI comprised group B. Positive lymph nodes (63 vs. 44 %, p  < 0.001) and positive surgical margins (34 % vs. 14 %, p  < 0.001) were more common in patients with cSVI. The 5- and 10-year cancer-specific survival rates were 41 % and 32 % (group A) and 21 and 17 % (group B) ( p  < 0.001). In multivariable analysis, pathological nodal stage (hazard ratio [HR] 2.19, p  < 0.001), soft tissue surgical margin (HR 1.57, p  = 0.010), clinical tumor stage (HR 1.46, p  = 0.010), adjuvant chemotherapy (HR 0.40, p  < 0.001), and cSVI (HR 1.69, p  < 0.001) independently impacted cancer-specific mortality. The c-indices of the multivariable models with and without inclusion of cSVI were 0.658 (95 % confidence interval 0.60–0.71) and 0.635 (95 % confidence interval 0.58–0.69), respectively, resulting in a predictive accuracy gain of 2.3 % ( p  = 0.002). Conclusions In patients with UCB and prostatic stromal invasion, cSVI adversely affected cancer-specific survival compared to patients without cSVI. The inclusion of cSVI significantly improved the predictive accuracy of our multivariable model regarding survival.