868 THE RATE OF SIDE SPECIFIC ECE IS CLOSELY RELATED TO THE RATE OF IPSILATERAL LYMPH NODE INVASION IN PATIENTS UNDERGOING RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Advanced III1 Apr 2010868 THE RATE OF SIDE SPECIFIC ECE IS CLOSELY RELATED TO THE RATE OF IPSILATERAL LYMPH NODE INVASION IN PATIENTS UNDERGOING RADICAL PROSTATECTOMY Lars Budäus, Pierre I. Karakiewicz, Jan Spethmann, Georg Salomon, Giovanni Lughezzani, Maxine Sun, Alexander Haese, Hartwig Huland, and Markus Graefen Lars BudäusLars Budäus Hamburg, Germany More articles by this author , Pierre I. KarakiewiczPierre I. Karakiewicz Montreal, Canada More articles by this author , Jan SpethmannJan Spethmann Hamburg, Germany More articles by this author , Georg SalomonGeorg Salomon Hamburg, Germany More articles by this author , Giovanni LughezzaniGiovanni Lughezzani Montreal, Canada More articles by this author , Maxine SunMaxine Sun Montreal, Canada More articles by this author , Alexander HaeseAlexander Haese Hamburg, Germany More articles by this author , Hartwig HulandHartwig Huland Hamburg, Germany More articles by this author , and Markus GraefenMarkus Graefen Hamburg, Germany More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1624AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Several risk stratification schemes are available for the prediction of the need for extended pelvic lymph adenectomy (ePLAD) in patients with prostate cancer undergoing radical prostatectomy (RP). None of those tools rely on pathological diagnosis. We examined the relationship between ECE and side specific and overall rate of LNI at ePLND. METHODS Between 1996 and 2008, 4806 patients underwent a RP with a ePLAD at a single European institution. Clinical and pathological information was available for 4790 men. Analyses were performed using the entire dataset as well as in a side specific fashion, where each lobe of the prostate and ipsilateral lymph node invasion was considered without accounting for contra lateral finding. RESULTS Overall, 7.9% of all patients undergoing LND had lymph node invasion (LNI). The rate of LNI was 0.8% in absence of ECE vs. 5.7 % and 15.1% when respectively side specific ECE or bilateral ECE was recorded. The rate of concordance (75.5%) between side specific ECE and side of LNI was statistical significant (p<0.001) and independent predictor status of ECE, (none vs. sidespecific (O.R. 5,66; p<0.001)) and (none vs. bilateral (O.R. 10,97; p<0.001)) was confirmed in multivariable models including PSA, biopsy Gleason sum and clinical stage. CONCLUSIONS Single sided ECE might indicate the predominant localization of the main tumor within the prostate. Our data demonstrated a relationship between ECE and the risk of ipsilateral LNI. These findings should be considered in future studies, including assessment of preoperative side specific tumor characteristics and side specific index tumor volume for testing the ability of developing side specific LNI prediction tools. These prediction tools could enable the surgeon to better decide if in such patients a side specific extended or pelvic LND is required. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e339 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lars Budäus Hamburg, Germany More articles by this author Pierre I. Karakiewicz Montreal, Canada More articles by this author Jan Spethmann Hamburg, Germany More articles by this author Georg Salomon Hamburg, Germany More articles by this author Giovanni Lughezzani Montreal, Canada More articles by this author Maxine Sun Montreal, Canada More articles by this author Alexander Haese Hamburg, Germany More articles by this author Hartwig Huland Hamburg, Germany More articles by this author Markus Graefen Hamburg, Germany More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...