Presence of lymph nodes and metastasis within prostatic anterior fat pad in radical prostatectomy patients: A single Chinese institution experience and literature review.

ABSTRACT

INTRODUCTION: Limited data from China, aim to investigate the incidence and the risk fctors of lymph node metastases in the prostatic anterior fat pad (PAFP). MATERIAL AND METHODS: Patients underwent radical prostatectomy (RP) were enrolled between March 2020 to December 2022 at a single institution. Separate pathological analysis of PAFP was performed within this area. Univariate analysis and Multivariate analysis were performed to determine the risk factor of PAFP metastasis. RESULT: A total of 255 patients were included. The study revealed an average age of 67.72 ± 7.07 years, with a mean total tumor volume of 41.54 ± 23.79 mL, and an average Pre-op PSA of 16.85 ng/mL. Clinical T stage was divided into T2, T3, and T4 (226, 25, 4 cases, respectively), while the Clinical M stage was categorized as M0 and M1 (248 and 7 cases, respectively). Out of the patients with PAFP, 19 (7.45 %) had lymph node in PAFP, and 3 (1.18 %) patients had metastases. In the univariate and multivariate analysis, Clinical M stage and anterior primary tumor were found to be a significant high-risk factor. Among the other 15 studies, six examined the risk factors associated with it, including anterior tumors, higher tumour volume, intermediate or high risk prostate cancer. CONCLUSION: Due to the low proportion of lymph node involvement (7.45 %) and rare tumor metastasis (1.18 %), routine separate pathological analysis of PAFP is not recommended in all RP patients unless there are anterior tumors, higher tumor volume, or intermediate/high risk prostate cancer.