Validation study on the 2 mm diameter cutoff in lymph node-positive cases following radical prostatectomy in accordance with the AJCC/UICC TNM 8th edition: Real-world data analysis from a Japanese cohort.
Int J Urol
; 31(6): 662-669, 2024 Jun.
Article
in En
| MEDLINE
| ID: mdl-38424729
ABSTRACT
OBJECTIVES:
The American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) 8th edition has proposed micrometastasis as a lymph node metastasis (LN+) of diameter ≤2 mm in prostate cancer. However, supporting evidence has not described. We evaluated LN+ patients' survival after radical prostatectomy (RP) based on the LN maximum tumor diameter (MTD).METHODS:
Data from 561 LN+ patients after RP and pelvic LN dissection (PLND) treated between 2006 and 2019 at 33 institutions were retrospectively investigated. Patients were stratified by a LN+ MTD cutoff of 2 mm. Outcomes included castration resistance-free survival (CRFS), metastasis-free survival (MFS), cancer-specific survival (CSS), and overall survival (OS).RESULTS:
In total, 282 patients were divided into two groups (LN+ MTD >2 mm [n = 206] and ≤2 mm [n = 76]). Patients of LN+ status >2 mm exhibited significantly decreased CRFS and MFS, and poorer CSS and OS. No patients developed CRPC in the LN+ status ≤2 mm group when the PLND number was ≥14. Multivariate analysis showed the number of LN removed, RP Gleason pattern 5, and MTD in LN+ significantly predicted CRFS.CONCLUSIONS:
Patients of LN+ status ≤2 mm showed better prognoses after RP. In all the patients in the ≤2-mm group, the progression to CRPC could be prevented with appropriate interventions, particularly when PLND is performed accurately. Our findings support the utility of the pN substaging proposed by the AJCC/UICC 8th edition; this will facilitate precision medicine for patients with advanced prostate cancer.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Prostatectomy
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Prostatic Neoplasms
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Lymph Node Excision
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Lymph Nodes
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Lymphatic Metastasis
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Neoplasm Staging
Limits:
Aged
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Humans
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Male
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Middle aged
Country/Region as subject:
Asia
Language:
En
Journal:
Int J Urol
Journal subject:
UROLOGIA
Year:
2024
Document type:
Article
Affiliation country:
Country of publication: