[Prostate adenocarcinoma. Predictive clinical model of seminal vesicle involvement]. / Adenocarcinoma de próstata. Modelo clínico predictivo de afectación de vesícula seminal.

ABSTRACT

OBJECTIVES: Our aim is to design a predictive model of seminal vesicle involvement. using clinical data. METHODS: We studied 1128 patients with clinically localized adenocarcinoma treated by radical prostatectomy (127 were pT3b). We identified (logistic regression) clinical variables related with pT3b. With the multivariate study influential variables a seminal vesicle involvement risk model is designed. RESULTS: Seminal vesicle involvement related factors In univariate study the influential variables are Gleason 7 (OR2);Gleason 8-10 (OR4.5) T2 (OR2.6); bilateral involvement in biopsy (OR3.1); PSA 10-20 ng/ml ( OR3.3); PSA >20 ng/ ml (OR9.5). In the multivariate study are influential Gleason 7 (OR1.56) Gleason 8-10 ( OR 3.4); T2 (OR1.9); PSA 10-20 ng/ml (OR3.1) and PSA >20 ng/,ml (OR8.8). Predictive model using multivariate logistic regression the weight of each variable is valued and a value between 1 and 4 is given. Gleason 2-6, T1; PSA<10 ng/ml value 1; Gleason 7; T2 y PSA 10-20 ng/ml value 2; Gleason 8-10 and PSA >20 ng/ml value 4. Each patient has a marker that fluctuates between 3 and 10. 5 Groups are designed with significantly different risks (p<0.05 in all cases ) Group 1 (3 points) (OR1) (risk 2.4% 95%IC 0.7%-4.3%) Group 2 (4 points) (OR2.7) (risk 6.5% 95%IC 5%-7.9%); Group 3(5-6 points) (OR7.1)( risk15% 95%IC 11%-19%) Group 4 ( 7--8 points) (OR33.4) (risk 45.5%; 95%IC 30%-59%) Group 5 (9-10 points) (OR57.3) (risk 58.8% 95%IC 35%- 82%). CONCLUSION: The clinical model allows an accurate approximation to the seminal vesicles involvement risk.