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Randomized Controlled Trial
. 2008 Dec;180(6):2453-7; discussion 2458.
doi: 10.1016/j.juro.2008.08.037. Epub 2008 Oct 19.

The prognostic impact of seminal vesicle involvement found at prostatectomy and the effects of adjuvant radiation: data from Southwest Oncology Group 8794

Gregory P Swanson  1 , Bryan Goldman, Catherine M Tangen, Joseph Chin, Edward Messing, Edith Canby-Hagino, Jeffrey D Forman, Ian M Thompson, E David Crawford; outhwest Oncology Group 8794
Affiliations
Randomized Controlled Trial

The prognostic impact of seminal vesicle involvement found at prostatectomy and the effects of adjuvant radiation: data from Southwest Oncology Group 8794

Gregory P Swanson et al. J Urol. 2008 Dec.

Abstract

Purpose: From the randomized study Southwest Oncology Group 8794 we evaluated the effect of seminal vesicle involvement on outcomes and whether those patients benefited from post-prostatectomy adjuvant radiation therapy.

Materials and methods: Southwest Oncology Group study 8794 randomized high risk patients (with seminal vesicle positive disease and/or capsular penetration and/or positive margins) to radiation vs observation after prostatectomy. A total of 431 subjects with pathologically advanced prostate cancer were randomized.

Results: Median followup was 12.2 years. Of the patients 139 had seminal vesicle involvement with or without capsular penetration and/or positive margins. Compared to the 286 patients with seminal vesicle negative disease there was poorer 10-year biochemical failure-free survival (33% for seminal vesicle negative and 22% for seminal vesicle positive, p = 0.04), metastasis-free survival (70% and 56%, respectively, p = 0.005) and overall survival (10-year overall survival 74% and 61%, respectively, p = 0.02) for those with seminal vesicle positive disease. Patients with seminal vesicle positive disease who received adjuvant radiation compared to observation realized an improvement in 10-year biochemical failure-free survival from 12% to 36% (p = 0.001), in 10-year overall survival from 51% to 71% (p = 0.08) and in metastasis-free survival from 47% to 66% (p = 0.09), respectively.

Conclusions: Although seminal vesicle involvement is a negative prognostic factor, long-term control is possible especially if patients are given adjuvant radiation therapy. This therapy appears to be effective in patients with seminal vesicle involvement.

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Figures

Figure 1
Figure 1
Overall survival in high risk patients, impact of SV involvement.
Figure 2
Figure 2
Biochemical failure free survival for radiation and observation high risk patients as influenced by seminal vesicle involvement.
Figure 3
Figure 3
High risk patients with positive seminal vesicles. Impact of radiation on survival.
See this image and copyright information in PMC

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