The incidence and significance of seminal vesicle invasion in patients with adenocarcinoma of the prostate.

The incidence and significance of seminal vesicle invasion in patients with adenocarcinoma of the prostate were determined in 139 patients who underwent radical prostatectomy. Of the 36 patients who had seminal vesicle invasion, 27 (75%) also had capsular invasion and 13 (43%) had lymph node metastases. Disease progression rates were 31% and 58% at 5 and 8 years, respectively. Survival rate at 5 years was 90.6% and at 8 years it was 83.7%. Of the 103 patients without seminal vesicle invasion, 21 (20.4%) also had capsular invasion and 11 (12%) had lymph node metastases. Disease progression rates were 2.5% and 15.7% at 5 and 8 years, respectively. Survival rate at both 5 and 8 years was 98.4%. These data suggest that the majority of patients with seminal invasion do not have lymph node metastases on presentation and thus they cannot be detected by lymph node dissection before radical prostatectomy. Improved techniques for preoperative detection of seminal vesicle invasion can assist in patient selection for surgery and improve the results of radical prostatectomy.