MP32-16 LYMPH NODE DENSITY AND BIOCHEMICAL RECURRENCE IN PATIENTS POST ROBOTIC ASSISTED RADICAL PROSTATECTOMY WITH EXTENDED PELVIC LYMPH NODE DISSECTION

Abstract

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History II (MP32)1 Sep 2021MP32-16 LYMPH NODE DENSITY AND BIOCHEMICAL RECURRENCE IN PATIENTS POST ROBOTIC ASSISTED RADICAL PROSTATECTOMY WITH EXTENDED PELVIC LYMPH NODE DISSECTION Jeannie Su, Rebeka Dejenie, Shu-Ching Chang, and Timothy Wilson Jeannie SuJeannie Su More articles by this author , Rebeka DejenieRebeka Dejenie More articles by this author , Shu-Ching ChangShu-Ching Chang More articles by this author , and Timothy WilsonTimothy Wilson More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002036.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Men with node positive prostate cancer were historically treated with immediate adjuvant therapy, but not all node positive patients experience biochemical recurrence (BCR) or require additional therapy. Lymph node (LN) yield (LNY) during pelvic lymph node dissection (PLND) for prostate cancer has increased in recent years with robotic surgery and extended (e) templates. We sought to define the optimal LN density (LND) and its association with BCR in patients after robotic assisted radical prostatectomy (RARP) with ePLND. METHODS: This was a retrospective single surgeon study looking at 189 patients who underwent RARP with eBPLND between 2015 to 2019. Patients with any prior therapy were omitted. The Briganti 2012 and 2018 nomograms (cut off 7%) determined need for ePLND. Optimal LND (positive nodes/LNY) was determined with the Classification and Regression Tree amongst LN positive patients. Kaplan-Meier method and Cox proportional-hazards regression with inverse probability weighting (IPTW) using propensity score method were used to determine the association of LN involvement and LND to BCR. BCR was defined as PSA ≥0.2. RESULTS: 136 patients were LN negative (N0) and 53 were LN positive (N1). Median LNY was 26 (IQR 20, 36) in N0 patients and 32 (IQR 26, 40) in N1 patients (p <0.05). Median time to last negative follow up or BCR was 21.4 (IQR 13.3, 34.7) months. N1 patients had shorter median time to recurrence (p <0.01; figure 1a). Amongst N1 patients, optimal LND cut off was 5%. Median time to BCR was shorter in patients with high LND (p=0.04; figure 1b). On multivariate analysis, although nodal status was not significantly associated with BCR (Hazard Ratio, HR 1.39 (95%CI 0.88-2.2); p=0.153), high LND had higher risk of BCR (HR 1.91 (1.01-3.6); p=0.046) (table 1ab). CONCLUSIONS: Not all N1 prostate cancer patients have BCR or require adjuvant therapy. Patients with a LND greater than 5% are more likely to recur sooner than those less than 5%. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e572-e573 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jeannie Su More articles by this author Rebeka Dejenie More articles by this author Shu-Ching Chang More articles by this author Timothy Wilson More articles by this author Expand All Advertisement Loading ...