Re-evaluating the biological significance of seminal vesicle invasion (SVI) in locally advanced prostate cancer

Department of Surgery, University of Melbourne, Royal Melbourne Hospital, Parkville and the Australian Prostate Cancer Research CentreEpworth, Richmond TissuPath Specialist Pathology, Mount Waverley, Monash University Faculty of Medicine, VIC, Australia.
BJU International (Impact Factor: 3.53). 12/2012; 110 Suppl 4(S4):58-63. DOI: 10.1111/j.1464-410X.2012.11477.x
Source: PubMed


•  To examine the impact of seminal vesicle invasion (SVI) in patients with locally advanced (pT3) prostate cancer on clinical outcome. •  To explore the clinical association of SVI with metastatic disease. •  To distinguish between the possibilities that either seminal vesicles possess their own biological significance and represent a privileged staging site for systemic tumour cell dissemination, or that their invasion is a surrogate marker for an aggressive large-volume poorly differentiated cancer.
•  Patients with extraprostatic extension (EPE) and/or SVI were identified from a prospectively recorded and maintained prostate cancer database. •  Patients were categorised according to the presence of SVI as determined by routine pathological assessment. Tumour volumes were measured routinely by computed planimetry at the time of histological assessment. •  The impact of SVI on biochemical recurrence with a definition of a prostate-specific antigen (PSA) level of ≥0.2 ng/mL, as well as a clinically significant recurrence defined as failure with a PSA doubling time of <6 months, was determined by univariable and multivariable Cox regression analysis.
•  Of 249 patients with pT3 disease, 46 (18%) had SVI, 40 (87%) by direct extension and six (13%) metastatic. •  Tumours with SVI had significantly greater tumour burden as determined by total tumour volume (7.2 vs 3.7 mL, P < 0.001), index tumour volume (6.8 vs. 3.4 mL, P < 0.001) and percentage tumour volume (21.8 vs 12.4 %, P= 0.001). •  After controlling for tumour volume and Gleason score, the presence of SVI did not significantly predict for the development of a significant PSA recurrence.
•  Our results suggest that SVI is a surrogate marker of larger and more aggressive tumours with higher Gleason scores rather than a privileged site of tumour cell dissemination.

Download full-text


Available from: John Pedersen, Sep 24, 2014
1 Follower
42 Reads
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: microRNAs (miRNAs) are a growing class of small non-coding RNAs that exhibit widespread dysregulation in prostate cancer. We profiled miRNA expression in syngeneic human prostate cancer cell lines that differed in their metastatic potential in order to determine their role in aggressive prostate cancer. miR-888 was the most differentially expressed miRNA observed in human metastatic PC3-ML cells relative to non-invasive PC3-N cells, and its levels were higher in primary prostate tumors from cancer patients, particularly those with seminal vesicle invasion. We also examined a novel miRNA-based biomarker source called expressed prostatic secretions in urine (EPS urine) for miR-888 expression and found that its levels were preferentially elevated in prostate cancer patients with high-grade disease. These expression studies indicated a correlation for miR-888 in disease progression. We next tested how miR-888 regulated cancer-related pathways in vitro using human prostate cancer cell lines. Overexpression of miR-888 increased proliferation and migration, and conversely inhibition of miR-888 activity blocked these processes. miR-888 also increased colony formation in PC3-N and LNCaP cells, supporting an oncogenic role for this miRNA in the prostate. Our data indicates that miR-888 functions to promote prostate cancer progression and can suppress protein levels of the tumor suppressor genes RBL1 and SMAD4. This miRNA holds promise as a diagnostic tool using an innovative prostatic fluid source as well as a therapeutic target for aggressive prostate cancer.
    Cell cycle (Georgetown, Tex.) 11/2013; 13(2). DOI:10.4161/cc.26984 · 4.57 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: A radical prostatectomy affects the prostate, bilateral seminal vesicles (SV), and the distal parts of the bilateral vasa deferentia (VD). SV invasion (SVI) is associated with an increased risk of lymph node metastasis and recurrence. However, the significance of VD invasion (VDI), either with or without the involvement of their surgical margins, has not been fully appreciated. We think VDI might have an independent prognostic significance, as does SVI, and should be incorporated into the pathology guidelines and the staging systems of prostatic adenocarcinoma. Our case illustrates this.
    07/2014; 8(7-8):E554-7. DOI:10.5489/cuaj.1802
  • [Show abstract] [Hide abstract]
    ABSTRACT: Multiparametric magnetic resonance (MR) imaging of the prostate is gaining acceptance in the management of prostate cancer. Emerging indications of prostate MR imaging may expand its use in the work-up of localized prostate cancer. Improvements in the standardization of prostate MR imaging techniques and reporting are needed for further establishment of the emerging roles of prostate MR imaging. This article describes the prostate MR imaging techniques and provides an approach for interpretation of prostate MR imaging studies. Established and emerging indications for prostate MR imaging are also reviewed.
    Radiologic Clinics of North America 07/2014; 52(4):811-837. DOI:10.1016/j.rcl.2014.02.010 · 1.98 Impact Factor