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The Association Between Total and Positive Lymph Node Counts, and Disease Progression in Clinically Localized Prostate Cancer

2006; Lippincott Williams & Wilkins; Volume: 175; Issue: 4 Linguagem: Inglês

10.1016/s0022-5347(05)00685-3

1527-3792

Timothy A. Masterson, Fernando J. Bianco, Andrew J. Vickers, Christopher J. DiBlasio, Paul Fearn, Farhang Rabbani, James A. Eastham, Peter T. Scardino,

Urologic and reproductive health conditions

No AccessJournal of UrologyAdult urology1 Apr 2006The Association Between Total and Positive Lymph Node Counts, and Disease Progression in Clinically Localized Prostate Cancer Timothy A. Masterson, Fernando J. Bianco, Andrew J. Vickers, Christopher J. DiBlasio, Paul A. Fearn, Farhang Rabbani, James A. Eastham, and Peter T. Scardino Timothy A. MastersonTimothy A. Masterson Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, New York , Fernando J. BiancoFernando J. Bianco Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, New York , Andrew J. VickersAndrew J. Vickers Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, New York Department of Biostatistics and Epidemiology, Memorial Sloan-Kettering Cancer Center, New York, New York , Christopher J. DiBlasioChristopher J. DiBlasio Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, New York , Paul A. FearnPaul A. Fearn Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, New York , Farhang RabbaniFarhang Rabbani Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, New York Department of Biostatistics and Epidemiology, Memorial Sloan-Kettering Cancer Center, New York, New York , James A. EasthamJames A. Eastham Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, New York , and Peter T. ScardinoPeter T. Scardino Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, New York View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)00685-3AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We examined the association between the number of LNs removed, the number of positive LNs and disease progression in patients undergoing pelvic lymph node dissection and radical retropubic prostatectomy for clinically localized prostate cancer. Materials and Methods: We analyzed 5,038 consecutive patients who underwent radical retropubic prostatectomy between 1983 and 2003. Clinicopathological parameters, including the administration of neoadjuvant hormonal therapy, preoperative prostate specific antigen, specimen Gleason score, surgeon and pathological stage, were collected prospectively in our prostate cancer database. We excluded men treated with radiation or chemotherapy before surgery. BCR was defined as 2 postoperative prostate specific antigen increases greater than 0.2 ng/ml. Cox models were used to determine whether the number of nodes removed or the number of positive nodes predicted freedom from BCR after adjustment for prognostic covariates. Results: The 4,611 eligible patients had a median of 9 LNs (IQR 5 to 13) removed. Positive nodes were found in 175 patients (3.8%). Overall the number of LNs removed did not predict freedom from BCR (HR per additional 10 nodes removed 1.02, 95% CI 0.92 to 1.13, p = 0.7). Results were similar in patients receiving and not receiving neoadjuvant hormonal therapy. Finding any LN involvement was associated with a BCR HR of 5.2 (95% CI 4.2 to 6.4, p <0.0005). However, in men without nodal involvement an increased number of nodes removed correlated significantly with freedom from BCR (p = 0.01). Conclusions: Nodal disease increased the risk of progression. 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Crossref, Medline, Google Scholar © 2006 by American Urological AssociationFiguresReferencesRelatedDetailsCited byEastham J, Auffenberg G, Barocas D, Chou R, Crispino T, Davis J, Eggener S, Horwitz E, Kane C, Kirkby E, Lin D, McBride S, Morgans A, Pierorazio P, Rodrigues G, Wong W and Boorjian S (2022) Clinically Localized Prostate Cancer: AUA/ASTRO Guideline, Part II: Principles of Active Surveillance, Principles of Surgery, and Follow-UpJournal of Urology, VOL. 208, NO. 1, (19-25), Online publication date: 1-Jul-2022.Sanda M, Cadeddu J, Kirkby E, Chen R, Crispino T, Fontanarosa J, Freedland S, Greene K, Klotz L, Makarov D, Nelson J, Rodrigues G, Sandler H, Taplin M and Treadwell J (2018) Clinically Localized Prostate Cancer: AUA/ASTRO/SUO Guideline. Part II: Recommended Approaches and Details of Specific Care OptionsJournal of Urology, VOL. 199, NO. 4, (990-997), Online publication date: 1-Apr-2018.Kim I, Modi P, Sadimin E, Ha Y, Kim J, Skarecky D, Cha D, Wambi C, Ou Y, Yuh B, Park S, Llukani E, Albala D, Wilson T, Ahlering T, Badani K, Ahn H, Lee D, May M, Kim W and Lee D (2013) Detailed Analysis of Patients with Metastasis to the Prostatic Anterior Fat Pad Lymph Nodes: A Multi-Institutional StudyJournal of Urology, VOL. 190, NO. 2, (527-534), Online publication date: 1-Aug-2013.Abdollah F, Sun M, Suardi N, Gallina A, Capitanio U, Bianchi M, Tutolo M, Passoni N, Karakiewicz P, Rigatti P, Montorsi F and Briganti A (2012) National Comprehensive Cancer Network Practice Guidelines 2011: Need for More Accurate Recommendations for Pelvic Lymph Node Dissection in Prostate CancerJournal of Urology, VOL. 188, NO. 2, (423-428), Online publication date: 1-Aug-2012.von Bodman C, Godoy G, Chade D, Cronin A, Tafe L, Fine S, Laudone V, Scardino P and Eastham J (2010) Predicting Biochemical Recurrence-Free Survival for Patients With Positive Pelvic Lymph Nodes at Radical ProstatectomyJournal of Urology, VOL. 184, NO. 1, (143-148), Online publication date: 1-Jul-2010.Wagner M, Sokoloff M and Daneshmand S (2007) The Role of Pelvic Lymphadenectomy for Prostate Cancer—Therapeutic?Journal of Urology, VOL. 179, NO. 2, (408-413), Online publication date: 1-Feb-2008.Boorjian S, Thompson R, Siddiqui S, Bagniewski S, Bergstralh E, Karnes R, Frank I and Blute M (2007) Long-Term Outcome After Radical Prostatectomy for Patients With Lymph Node Positive Prostate Cancer in the Prostate Specific Antigen EraJournal of Urology, VOL. 178, NO. 3, (864-871), Online publication date: 1-Sep-2007. Volume 175Issue 4April 2006Page: 1320-1325 Advertisement Copyright & Permissions© 2006 by American Urological AssociationKeywordslymph node excisionprostatelymph nodeslocalprostatic neoplasmsneoplasm recurrenceMetricsAuthor Information Timothy A. Masterson Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, New York More articles by this author Fernando J. Bianco Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, New York More articles by this author Andrew J. Vickers Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, New York Department of Biostatistics and Epidemiology, Memorial Sloan-Kettering Cancer Center, New York, New York More articles by this author Christopher J. DiBlasio Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, New York More articles by this author Paul A. Fearn Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, New York More articles by this author Farhang Rabbani Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, New York Department of Biostatistics and Epidemiology, Memorial Sloan-Kettering Cancer Center, New York, New York More articles by this author James A. Eastham Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, New York More articles by this author Peter T. Scardino Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, New York More articles by this author Expand All Advertisement PDF downloadLoading ...