298 LONG-TERM OUTCOMES FOR PROSTATE CANCER PATIENTS WITH LYMPH NODE METASTASIS AFTER RADICAL PROSTATECTOMY (2011)

You have accessJournal of UrologyProstate Cancer: Staging1 Apr 2011298 LONG-TERM OUTCOMES FOR PROSTATE CANCER PATIENTS WITH LYMPH NODE METASTASIS AFTER RADICAL PROSTATECTOMY Clarisse Mazzola, Youness Ahallal, Tarek Ghoneim, Daniel Sjoberg, Bertrand Guillonneau, James Eastham, Peter Scardino, and Karim Touijer Clarisse MazzolaClarisse Mazzola New York, NY More articles by this author , Youness AhallalYouness Ahallal New York, NY More articles by this author , Tarek GhoneimTarek Ghoneim New York, NY More articles by this author , Daniel SjobergDaniel Sjoberg New York, NY More articles by this author , Bertrand GuillonneauBertrand Guillonneau New York, NY More articles by this author , James EasthamJames Eastham New York, NY More articles by this author , Peter ScardinoPeter Scardino New York, NY More articles by this author , and Karim TouijerKarim Touijer New York, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.391AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Lymph node metastasis at the time of radical prostatectomy (RP) is a poor prognostic indicator. Only a small proportion of men (15%–20%) have been reported to remain free from biochemical recurrence (BCR) on the long-term. We evaluated the long-term outcomes of men with node positive prostate cancer in our RP experience. METHODS 445 men who were treated by RP, between 1987 and 2009 were found to have positive lymph node involvement. 12 patients with prior metastasis and 29 patients who had a salvage RP were removed from all analyses. An additional 27 patients were excluded due to lack of follow-up after RP, leaving 377 patients included in the analyses. Our aim was to describe overall survival, survival from prostate cancer, metastasis-free progression, and BCR-free progression. Each of these outcomes is represented with a Kaplan-Meier curve. Men who had a metastasis after RP and died from an unknown cause were assumed to have died from prostate cancer (n=17). RESULTS The median age at surgery was 62 (IQR 57, 66). The majority of men had extracapsular extension (n=351; 95%) and Gleason grade 7 or higher (n=335; 99%). 166 (45%) men had seminal vesical invasion. Overall, 60 patients with LNI died, 41 from prostate cancer. 80 patients developed metastasis and 187 patients experienced BCR after RP. The 5 and 10 year probability of being alive and being free from prostate cancer death was 88% (95% CI 82%, 92%) and 64% (95% CI 53%, 73%), and 92% (95% CI 86%, 95%) and 71% (95% CI 60%, 79%), respectively. The 5 and 10 year probability of being free from metastasis and BCR was 73% (95% CI 66%, 78%) and 69% (95% CI 60%, 76%) and 35% (95% CI 28%, 42%) and 30% (95% CI 21%, 37%), respectively. Increased pathologic Gleason Grade (Gleason <=7 vs. Gleason Grade >7, HR=2.54, 95% CI 1.75, 3.70) and having 3 or more positive lymph nodes removed (HR=1.69, 95% CI 1.11, 2.55) were significantly associated with an increased risk of biochemical recurrence after RP in a multivariable Cox proportional hazard regression model. CONCLUSIONS In our experience, 30% of men with metastatic nodal disease remained free of disease 10 years after RP. Those with pathological Gleason score less than 8 and low nodal metastatic burden (less than 2 positive nodes) represent a very favorable group with remarkable 10 year freedom from progression. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e121 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Metrics Author Information Clarisse Mazzola New York, NY More articles by this author Youness Ahallal New York, NY More articles by this author Tarek Ghoneim New York, NY More articles by this author Daniel Sjoberg New York, NY More articles by this author Bertrand Guillonneau New York, NY More articles by this author James Eastham New York, NY More articles by this author Peter Scardino New York, NY More articles by this author Karim Touijer New York, NY More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...