Abstract
BackgroundThe aim of the study was to evaluate the therapeutic role of pelvic lymph node dissection (PLND) and its extent in North American patients with a risk of lymph node invasion (LNI)>5%. MethodsData of 20,668 patients treated with radical prostatectomy (RP) with and without PLND from SEER database between 2010 and 2015 were retrospectively analyzed. All patients had a risk of LNI>5% according to 2012-Briganti nomogram. Propensity score matching (PSM) was performed to balance baseline characteristics between patients with and without PLND. Kaplan-Meier curves and Cox regression were used to evaluate the impacts of the PLND and its extent on cancer-specific survival (CSS) and overall survival (OS). ResultsThe median follow-up was 32 months. In overall cohort, patients with PLND were associated with more aggressive clinicopathologic characteristics and had poorer survival compared to those without PLND (5-year CSS rate: 98.4% vs. 99.7%, p<0.001; 5-year OS rate: 96.3% vs. 97.8%, p<0.001). PSM resulted in 4,267 patients in each group. In the post-PSM cohort, no significant difference in survival was found between patients with and without PLND (5-year CSS rate: 99.4% vs. 99.7%, p=0.479; 5-year OS rate: 97.3% vs. 97.8%, p=0.204). In addition, the extent of PLND had no impact on prognosis (all p<0.05). Subgroup analyses reported similar negative findings. ConclusionsNeither PLND nor its extent was associated with survival in North American patients with a risk of LNI>5%. Legal entity responsible for the studyHao Zeng. FundingHas not received any funding. DisclosureAll authors have declared no conflicts of interest.
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