MP09-07 RISK OF LYMPH NODE METASTASES IN PATHOLOGICAL GLEASON SCORE =6 PROSTATE ADENOCARCINOMA: ANALYSIS OF INSTITUTIONAL AND POPULATION-BASED DATABASES

Abstract

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History II1 Apr 2016MP09-07 RISK OF LYMPH NODE METASTASES IN PATHOLOGICAL GLEASON SCORE =6 PROSTATE ADENOCARCINOMA: ANALYSIS OF INSTITUTIONAL AND POPULATION-BASED DATABASES Hannah Wenger, Aria Razmaria, Gladell Paner, Adam Weiner, and Scott Eggener Hannah WengerHannah Wenger More articles by this author , Aria RazmariaAria Razmaria More articles by this author , Gladell PanerGladell Paner More articles by this author , Adam WeinerAdam Weiner More articles by this author , and Scott EggenerScott Eggener More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2294AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To evaluate the incidence of lymph node metastases (LNM) in pathological Gleason score =6 prostate cancer (PCa) using data generated by the Surveillance, Epidemiology, and End Results (SEER) database, the National Cancer Database (NCDB), and an institutional database at the University of Chicago Medical Center (UCMC). METHODS Using the SEER (2004-2011, n=25,565) and NCDB (2004-2011, n=84,180) databases, we identified patients with pathological Gleason score (pGS) =6 PCa following radical prostatectomy and lymph node dissection. Multivariable logistic regressions were used to analyze factors predicting LNM. At UCMC (2003-2014), men with pGS=6 who did (n=267) and did not receive (n=770) a lymph node dissection were identified. The primary endpoint was LNM at surgery for all cohorts or evidence of metastatic disease on subsequent imaging for the UCMC cohort. Secondary endpoints for the UCMC cohort included biochemical recurrence (BCR) and response to salvage radiation therapy. RESULTS Positive lymph nodes were found in 0.3% of SEER patients and 0.31% of NCDB patients with pGS =6 PCa following radical prostatectomy and lymph node dissection. PSA, pathologic stage, and West and South geographic region were strong predictors of LNM. Among UCMC patients with pGS =6 PCa following radical prostatectomy and lymph node dissection, no LNM were found, and BCR occurred in 3 cases (1%). All 3 patients responded favorably to salvage radiation therapy, suggestive of local recurrence. A total of 21 patients from UCMC who did not receive a lymph node dissection had a BCR and received salvage radiation therapy. Of these, 4 had persistent detectable PSA levels without local or distant evidence of disease at a median of 65 months (range 29-79) following salvage radiation therapy. Of the 3 cases available for contemporary histopathologic review, all 3 were upgraded to pGS 7. CONCLUSIONS LNM from pGS=6 PCa are exceedingly rare (~0.3%) and may be attributable to variability in pathologic grading across institutions. As suggested by both our population-based and institutional analysis, lymph node metastases from Gleason 6 prostate cancer is either extremely rare or non-existent. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e96 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Hannah Wenger More articles by this author Aria Razmaria More articles by this author Gladell Paner More articles by this author Adam Weiner More articles by this author Scott Eggener More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...