473 OMISSION OF PELVIC LYMPHADENECTOMY IN LOW-RISK PROSTATE CANCER PATIENTS IS NOT ASSOCIATED WITH HIGHER RATES OF BIOCHEMICAL RECURRENCE AT FIVE YEARS

Abstract

You have accessJournal of UrologyProstate Cancer: Localized1 Apr 2011473 OMISSION OF PELVIC LYMPHADENECTOMY IN LOW-RISK PROSTATE CANCER PATIENTS IS NOT ASSOCIATED WITH HIGHER RATES OF BIOCHEMICAL RECURRENCE AT FIVE YEARS Joshua Logan, Michael Fabrizio, Robert Given, Stephen Riggs, and Raymond Lance Joshua LoganJoshua Logan Norfolk, VA More articles by this author , Michael FabrizioMichael Fabrizio Norfolk, VA More articles by this author , Robert GivenRobert Given Norfolk, VA More articles by this author , Stephen RiggsStephen Riggs Norfolk, VA More articles by this author , and Raymond LanceRaymond Lance Norfolk, VA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.567AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Several studies have reported a very low incidence of lymph node metastasis in D'Amico low-risk prostate cancer. Omission of the pelvic lymphadenectomy (PLND) has increased in this group. We evaluated whether omission of a PLND in these patients was associated with increased rates of biochemical recurrence (BCR) with long follow-up. METHODS The study population included 211 patients with prostate cancer clinical stage T1–2, Gleason 3+3, and PSA <10ng/ml. Patients were divided into two groups, those with PLND (+PL) at the time of prostatectomy (n = 88) and those without (–PL) (n = 123). Comparison of demographic and preoperative clinical characteristics are shown in Table 1. BCR was defined as PSA >0.2ng/ml within five years of surgery. Cox proportional hazards analysis was applied to evaluate the association between omission of PLND and BCR. RESULTS Median follow-up was 74.4 months. On Cox proportional hazards analysis omission of PLND was not a predictor of biochemical recurrence in –PL when compared to +PL (p = 0.30), figure 1. Other variables assessed and found not to be predictive of biochemical recurrence were: year of surgery (p = 0.44); age at surgery (p = 0.23); African-American race (p = 0.10); cT2 stage (p = 0.16); number of biopsy cores (p = 0.52); number of positive biopsy cores (p = 0.39); and percent positive cores (p = 0.62). PSA was the only pre-operative clinical variable found to predict BCR (p = 0.004). Table 2. CONCLUSIONS With long-term follow-up, D'Amico low-risk prostate cancers are no more likely to develop BCR when PLND is omitted than those who undergo PLND. A potentially confounding variable present is the limited extent of the PLND. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e192-e193 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Joshua Logan Norfolk, VA More articles by this author Michael Fabrizio Norfolk, VA More articles by this author Robert Given Norfolk, VA More articles by this author Stephen Riggs Norfolk, VA More articles by this author Raymond Lance Norfolk, VA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...