PD15-08 A MORE EXTENSIVE PELVIC LYMPH NODE DISSECTION IS ASSOCIATED WITH IMPROVED SURVIVAL OF PATIENTS WITH NODE POSITIVE PROSTATE CANCER (2014)

You have accessJournal of UrologyProstate Cancer: Staging I1 Apr 2014PD15-08 A MORE EXTENSIVE PELVIC LYMPH NODE DISSECTION IS ASSOCIATED WITH IMPROVED SURVIVAL OF PATIENTS WITH NODE POSITIVE PROSTATE CANCER Firas Abdollah, Nazareno Suardi, Alessandro Nini, Marco Moschini, Francesco Mistretta, Emanuele Zaffuto, Vito Cucchiara, Vincenzo Scattoni, Marco Bianchi, Vincenzo Mirone, Shahrokh F. Shariat, Giorgio Guazzoni, Francesco Montorsi, and Alberto Briganti Firas AbdollahFiras Abdollah More articles by this author , Nazareno SuardiNazareno Suardi More articles by this author , Alessandro NiniAlessandro Nini More articles by this author , Marco MoschiniMarco Moschini More articles by this author , Francesco MistrettaFrancesco Mistretta More articles by this author , Emanuele ZaffutoEmanuele Zaffuto More articles by this author , Vito CucchiaraVito Cucchiara More articles by this author , Vincenzo ScattoniVincenzo Scattoni More articles by this author , Marco BianchiMarco Bianchi More articles by this author , Vincenzo MironeVincenzo Mirone More articles by this author , Shahrokh F. ShariatShahrokh F. Shariat More articles by this author , Giorgio GuazzoniGiorgio Guazzoni More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Alberto BrigantiAlberto Briganti More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1297AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The association between the extent of pelvic lymph node dissection (PLND) and patient survival is currently a controversial topic in prostate cancer. Only a few retrospective reports found an association between the extent of PLND and patient outcome. However, these studies are limited by the lack of standardized anatomical template of nodal dissection. We therefore tested the association between the extent of nodal dissection and patient survival in a single center cohort of node positive patients treated with ePLND. METHODS The study included 540 consecutive node-positive patients treated with radical prostatectomy (RP) and anatomically defined extended pelvic lymph node dissection (ePLND) at a single European tertiary referral centre between 1992 and 2010. ePLND consisted of removal of obturator, external iliac, hypogastric +/- pre-sacral and common iliac lymph nodes. Kaplan-Meier curves assessed time to cancer specific and overall survival. Moreover, univariable and multivariable Cox regression analyses were performed to address predictors of cancer specific and overall mortality. Covariates consisted of patient age and PSA at surgery, pathological Gleason sum, pathological stage, number of positive lymph nodes, number of lymph nodes removed and adjuvant radiation and hormonal therapy. RESULTS Mean follow-up was 65 months (median: 63). Mean age at surgery was 65.5 yrs (median 66). Mean and median PSA at surgery was 26.6 and 11.5 ng/ml, respectively. Pathological stage was pT2, pT3a, pT3b and pT4 in 9.1%, 20%, 64.3% and 6.5% respectively. Pathological Gleason score 8-10 was present in 50.7% of patients. Mean and median number of lymph nodes removed were 21 and 19, respectively. Mean and median number of positive lymph nodes were 3.7 and 2, respectively. Adjuvant radiotherapy and hormonal therapy were given to 39.8 and 84.4%, respectively. The 8 and 10-year cancer specific and overall survival rates were 85 and 80%, and 73.4% and 70% . At multivariable analyses, after adjusting for all confounders, the number of lymph nodes removed was significantly inversely associated with both cancer specific and overall mortality (p= 0.02; HR: 0.92 and p=0.01; 0.93, respectively). The number of positive lymph nodes, pathological Gleason score 8-10 and adjuvant RT were also significantly associated with patient survival (all p≤0.02). CONCLUSIONS In node positive patients more extensive PLND is significantly associated with improved cancer specific and overall survival rates. Therefore, in these patients a meticulous PLND is advocated. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e418-e419 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Firas Abdollah More articles by this author Nazareno Suardi More articles by this author Alessandro Nini More articles by this author Marco Moschini More articles by this author Francesco Mistretta More articles by this author Emanuele Zaffuto More articles by this author Vito Cucchiara More articles by this author Vincenzo Scattoni More articles by this author Marco Bianchi More articles by this author Vincenzo Mirone More articles by this author Shahrokh F. Shariat More articles by this author Giorgio Guazzoni More articles by this author Francesco Montorsi More articles by this author Alberto Briganti More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...