Murat Can KARABURUN, Çağrı AKPINAR, Muhammed Arif İBİŞ, Ahmet Furkan ÖZSOY, Emre ERDEM, Ezgi Dicle SERBES, Saba KİREMİTCİ, Duygu ENNELİ, Çağatay GÖĞÜŞ, Kadir TÜRKÖLMEZ, Sümer BALTACI, Evren SÜER
Bulletin of Urooncology - 2026;25(2):31-37
Objective: To assess the impact of vas deferens invasion (VDI) on prognosis, as well as clinical and pathological outcomes in patients with pT3b prostate cancer. Materials and Methods: Patients reported as pT3b between 2010 and 2020 were included in the study. Patients were divided into two groups: Group 1 (VDI-) and Group 2 (VDI+). Biochemical recurrence-free survival (BCRFS) was compared using the Kaplan-Meier method with the log-rank test. Univariate and multivariate regression models were used to investigate the relationship between VDI and the risk of BCR. Results: The study included 199 patients with seminal vesicle invasion (SVI) on radical prostatectomy (RP) pathology. VDI was detected in 95 patients (47.7%). No differences was found between the two groups with respect to clinical and perioperative factors, including age, preoperative prostate-specific antigen (PSA), prostate volume, PSA density, biopsy International Society of Urological Pathology (ISUP) grade, clinical N stage, preoperative European Association of Urology risk group, surgery type (open or robotic), nerve-sparing approach, surgical margin status, number of resected lymph nodes (LN), and pathological LN positivity rates. The VDI+ group exhibited higher rates of extraprostatic extension and bilateral SVI, and a more advanced ISUP grade in RP pathology (p<0.05). The number of patients who received adjuvant hormone therapy was higher in the VDI+ group. Sixth-week PSA values were higher in the VDI+ group (p<0.05). No significant difference in BCRFS was observed (log-rank test; p=0.127). In multivariate logistic regression analysis, pN+ and RP ISUP grade were found to be significant predictors of BCR (p<0.05). Conclusion: Although the current study found that patients with VDI had lower BCRFS, the difference was not statistically significant. This condition may result from disparities in adjuvant treatments and other clinicopathological variables. Since the effect of VDI on prognosis in pT3b patients is not known, the results should be interpreted with caution. Patients with T3b prostate cancer may exhibit heterogeneous survival rates. Therefore, the indication of VDI in the pathology report appears to be an important consideration that can guide patient management.
