Prognostic factor indicates risk of cancer recurrence following radical prostatectomy

Slightly more than 10% of all patients who undergo successful surgery for prostate cancer have an elevated risk of tumor recurrence afterwards – especially as metastases. Under the microscope, it is possible to identify invasion of the tumour into the lymph and blood vessels, this being the tumour behaviour responsible for the formation of metastases, so that it can be used as a prognostic factor. This has now been demonstrated by Harun Fajkovic of MedUni Vienna's Department of Urology in a study involving 7,000 patients in "Urologic Oncology". Fajkovic will also report on the latest research findings at the largest international congress on prostate cancer "PROSCA", currently taking place in Vienna.

Lymphovascular invasion (LVI) means that malignant cancer cells "invade" the blood vessels and lymphatic system, from whence they can be transported onwards. "They can implant themselves, for example as micro-metastases in the lung or spine and then slowly replicate to form a new tumour at another site in the body," explains Fajkovic.

Detection of LVI, in combination with other characteristics in the pathological analysis of the resected tumour, therefore acts as a sort of alert, even if the patient's post-operative PSA value, the current marker for prostate cancer, is below the critical limit. Fajkovic: "Patients could then conceivably be offered additional supportive treatment straightaway, for example, radiotherapy or chemotherapy – rather than waiting to see." LVI has also been identified as an independent prognostic factor in other types of cancer, such as breast cancer or bladder cancer.

According to Statistik Austria (status 2013), around 5,000 men in Austria develop prostate cancer (adenocarcinoma) every year. Approximately 1,150 of those affected die over the same period. Prostate cancer is the third commonest male cancer worldwide.