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International Journal of Clinical Oncology
Erschienen in:

03.08.2020 | Original Article

Positive node burden rather than the number of removed nodes impacts survival in patients with node-positive prostate cancer

verfasst von: Xiao-xiao Guo, Run-qi Guo, Hui-min Hou, Xuan Wang, Jian-ye Wang, Ming Liu

Erschienen in: International Journal of Clinical Oncology | Ausgabe 12/2020

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Abstract

Background

The value of pelvic lymphadenectomy during radical prostatectomy (RP) remains controversial. This study aims to test the effects of the number of removed lymph nodes (RLN), positive nodes (pLN), and pLN ratio (pLNR) on cancer-specific survival (CSS) in patients with node-positive prostate cancer (PCa).

Methods

A total of 2458 patients with a greater than 5% probability of lymph node invasion according to the updated Briganti nomogram who harboured pathologically confirmed positive nodes in the Surveillance, Epidemiology, and End Results database between 2004 and 2015 were identified. Multivariable Cox regression with forward stepwise selection was performed to identify independent risk factors for CSS. Maximally selected rank statistics were used to determine the most informative cut-off value for pLN and pLNR.

Results

The median pLN counts and RLN in the study were two (interquartile range [IQR] 1– 3) and 18 (IQR 15–23), respectively. The RLN counts could not predict CSS, while the higher pLN and pLNR were associated with worse CSS (hazard ratio [HR], 1.11; p < 0.001 and HR, 1.01; p < 0.001, respectively). Patients with ≤ 2 pLN or pLNR ≤ 20% had significantly better CSS than those with pLN > 2 or pLNR > 20% (HR, 1.38 (1.08–1.77); p = 0.009; HR, 1.77 (1.41–2.22); p < 0.001, respectively).

Conclusions

In patients with node-positive PCa, pelvic lymphadenectomy provides important information for staging, prognosis, and guiding after RP therapy; however, it does not play a therapeutic role. The pLN counts and pLNR were independent predictors of CSS.
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Metadaten
Titel
Positive node burden rather than the number of removed nodes impacts survival in patients with node-positive prostate cancer
verfasst von
Xiao-xiao Guo
Run-qi Guo
Hui-min Hou
Xuan Wang
Jian-ye Wang
Ming Liu
Publikationsdatum
03.08.2020
Verlag
Springer Singapore
Erschienen in
International Journal of Clinical Oncology / Ausgabe 12/2020
Print ISSN: 1341-9625
Elektronische ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-020-01758-y

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