lymphovascular Invasion (LVI)

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K2
Regular Member


Date Joined Feb 2011
Total Posts : 51
   Posted 4/27/2011 4:26 PM (GMT -6)   
HW,

I'm researching the prognostic implications of LVI - any thoughts on the subject?

I've been reading a lot of nasty stuff about LVI as a strong indicator of PSA failure and DM. It appears not all agree as to it's prognostic role other than it's a negative pathological finding. Some failure rates cited are quite high - has anyone seen monograms that use LVI?

LVI does apparently provide a potential pathway for distant mets. I had 4 or 5 lymph nodes removed (all negative) but cancer could have taken residence in more distant locations. I guess the 10 dollar question is has the cancer spread beyond the local area (micromets?). If that's occurred then it's obviously a game changer.

There are some contra studies but they appear to be in the minority
http://www.asco.org/ascov2/Meetings/Abstracts?&vmview=abst_detail_view&confid=64&abstractid=20425

K2

Source:
http://www.nature.com/modpathol/journal/v24/n1/full/modpathol2010158a.html
Recently, the incidence of lymphovascular invasion in prostate cancer patients with pT3aN0 disease was found to range between 28% and 35%.13, 20 On univariate analysis, lymphovascular invasion was associated with a higher bpreoperative PSA and Gleason score in the prostatectomy specimen, but not with surgical margin status, biopsy Gleason score or clinical stage. In a multivariate analysis, preoperative PSA and lymphovascular invasion were identified as the only significant and independent predictors of PSA failure. When pT3aN0 prostate cancer patients were followed up without any treatment after radical prostatectomy, lymphovascular invasion was a significant and independent predictor of PSA failure and cancer progression. The 5-year PSA failure-free survival rate in patients with no lymphovascular invasion and PSA ≤10 ng/ml could be as high as 93.5%, suggesting that adjuvant therapy would not be indicated for this subset of patients. On the other hand, pT3aN0. patients with lymphovascular invasion had a poor prognosis, even when preoperative PSA was <10 ng/ml. In the study by May et al15 on node-negative prostate cancer patients treated by radical prostatectomy, lymphovascular invasion and Gleason score were independent predictors of biochemical failure, by multivariate analysis. The 5-year biochemical-free survival was 87.3% and 38.3% for patients without and with evidence of lymphovascular invasion in the radical prostatectomy specimen, respectively (P<0.001).

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 6079
   Posted 4/27/2011 4:44 PM (GMT -6)   
had no vascular invasion, but PNI, what me worry???
Diagnosed 8/14/09 psa 8.1 66,now 67
2cores 70%, rest 6-7 < 5%
gleason 3+ 3, up to 3+4 @ the dub
RPP U of Wash, Bruce Dalkin,
pathology 4+3, tertiary5, 2 foci
extensive pni, prostate confined,27 nodes removed -, svi - margins -
99%continent@ cath removal. 1% incont@gaspass,sneeze,cough 18 mos, squirt @ running. psa std test reported on paper as 0.0 as of 12/14/10 ed improving

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 4/28/2011 9:57 AM (GMT -6)   
K- looks like you did some decent looking into it thus far. Your web links...go back like you are going to edit your posting (edit=click on the top right box with the pencil icon=edit)
Then go to each link you have, then place your cursor at the end of the last letter (like you were going to add another letter to it), then push space bar and it will light up the link to make it a clickable event for us others. I found that works very well. I see you used Modern Pathology link (that source is looking good).

Those percentages you cited at the bottom of your post, are hugely significant in comparisons.
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