前列腺癌根治术标本中淋巴管或神经周围浸润与生化复发之间的关联。

The Association Between Lymphovascular or Perineural Invasion in Radical Prostatectomy Specimen and Biochemical Recurrence.

作者信息

Siech Carolin, Wenzel Mike, Grosshans Nico, Cano Garcia Cristina, Humke Clara, Koll Florestan Johannes, Tian Zhe, Karakiewicz Pierre I, Kluth Luis A, Chun Felix K H, Hoeh Benedikt, Mandel Philipp

机构信息

Goethe University Frankfurt, University Hospital, Department of Urology, 60590 Frankfurt am Main, Germany.

Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada.

出版信息

Cancers (Basel). 2024 Oct 29;16(21):3648. doi: 10.3390/cancers16213648.

DOI:10.3390/cancers16213648

PMID:39518086

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11545596/

Abstract

OBJECTIVE

The aim of this study was to test for the association between lymphovascular invasion or perineural invasion in radical prostatectomy (RP) specimens and biochemical recurrence (BCR).

METHODS

Relying on a tertiary-care database, we identified prostate cancer patients treated with RP between January 2014 and June 2023. Of these, the majority underwent robotic-assisted RP (81%). Kaplan-Meier survival analyses and Cox regression models addressed BCR according to either lymphovascular invasion or perineural invasion in RP specimens. Additionally, the linear trend test assessed the association between the Gleason Grade Group or pathologic tumor stage and lymphovascular or perineural invasion.

RESULTS

Of 822 patients, 78 (9%) exhibited lymphovascular invasion and 633 (77%) exhibited perineural invasion in RP specimens. In survival analyses, the five-year BCR-free survival rates were 62% in patients with lymphovascular invasion vs. 70% in patients without lymphovascular invasion ( = 0.04) and 64% in patients with perineural invasion vs. 82% in patients without perineural invasion ( = 0.01). In univariable Cox regression models, lymphovascular invasion (hazard ratio 1.58, 95% confidence interval 1.01-2.47; = 0.045) and perineural invasion (hazard ratio 1.77, 95% confidence interval 1.13-2.77; = 0.013) were both associated with a higher BCR rate. After accounting for age at surgery, PSA value, pathologic tumor stage, Gleason Grade Group, lymph node invasion, positive surgical margin, surgical approach, and adjuvant radiation therapy, lymphovascular ( = 0.740) or perineural invasion ( = 0.341) were not significantly associated with a higher BCR since the Gleason Grade Group and pathologic tumor stage highly correlated with lymphovascular as well as perineural invasion.

CONCLUSIONS

In univariable models, lymphovascular or perineural invasion is associated with BCR. After adjustment for standard pathologic tumor characteristics, lymphovascular or perineural invasion is not an independent predictor for BCR.

摘要

目的

本研究旨在检测根治性前列腺切除术（RP）标本中的淋巴管浸润或神经周围浸润与生化复发（BCR）之间的关联。

方法

基于一个三级医疗数据库，我们确定了2014年1月至2023年6月期间接受RP治疗的前列腺癌患者。其中，大多数患者接受了机器人辅助RP（81%）。采用Kaplan-Meier生存分析和Cox回归模型，根据RP标本中的淋巴管浸润或神经周围浸润情况分析BCR。此外，线性趋势检验评估了Gleason分级组或病理肿瘤分期与淋巴管或神经周围浸润之间的关联。

结果

在822例患者中，78例（9%）在RP标本中表现出淋巴管浸润，633例（77%）表现出神经周围浸润。在生存分析中，有淋巴管浸润患者的五年无BCR生存率为62%，无淋巴管浸润患者为70%（P = 0.04）；有神经周围浸润患者为64%，无神经周围浸润患者为82%（P = 0.01）。在单变量Cox回归模型中，淋巴管浸润（风险比1.58，95%置信区间1.01 - 2.47；P = 0.045）和神经周围浸润（风险比1.77，95%置信区间1.13 - 2.77；P = 0.013）均与较高的BCR率相关。在考虑手术年龄、PSA值、病理肿瘤分期、Gleason分级组、淋巴结浸润、手术切缘阳性、手术方式和辅助放疗后，由于Gleason分级组和病理肿瘤分期与淋巴管及神经周围浸润高度相关，淋巴管浸润（P = 0.740）或神经周围浸润（P = 0.341）与较高的BCR无显著关联。