Determinants of long-term survival of patients with locally advanced prostate cancer: the role of extensive pelvic lymph node dissection.
Prostate Cancer Prostatic Dis
; 19(1): 63-7, 2016 Mar.
Article
em En
| MEDLINE
| ID: mdl-26553644
ABSTRACT
BACKGROUND:
The therapeutic effect of pelvic lymph node dissection (PLND) during radical prostatectomy (RP) due to prostate cancer (PCa) is still under debate. We aimed at assessing the impact of more extensive PLND on cancer-specific mortality (CSM) in patients treated with surgery for locally advanced PCa.METHODS:
We examined data of 1586 pT3-T4 PCa patients treated with RP and extended PLND between 1987 and 2012 at a tertiary referral care center. Univariable and multivariable Cox regression analyses tested the relationship between the number of nodes removed and CSM rate, after adjusting for potential confounders. Survival estimates were based on the multivariable models.RESULTS:
The average number of nodes removed was 19 (median 17; interquartile range 11-23). Mean and median follow-up were 80 and 72 months, respectively. At multivariable analyses, Gleason score 8-10 (hazard ratio (HR) 2.5) and a higher number of positive nodes (HR 1.06) were independently associated with higher CSM rate (all P<0.05). Conversely, higher number of removed LNs (HR 0.94) and adjuvant radiotherapy (HR 0.54) were independent predictors of lower CSM rates (all P⩽0.03).CONCLUSIONS:
In pT3-T4 PCa patients, removal of a higher number of LNs during RP was associated with higher cancer-specific survival rates. This supports the role of more extensive PLNDs in this patient group. Further prospective studies are needed to validate our findings.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Próstata
/
Excisão de Linfonodo
/
Metástase Linfática
/
Recidiva Local de Neoplasia
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Prostate Cancer Prostatic Dis
Assunto da revista:
ENDOCRINOLOGIA
/
NEOPLASIAS
/
UROLOGIA
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Itália