MP57-17 EXTENT OF PELVIC LYMPH NODE DISSECTION IN LYMPH NODE NEGATIVE PROSTATE CANCER IS SIGNIFICANT IN PREDICTING RISK OF BIOCHEMICAL RECURRENCE

Abstract

INTRODUCTION AND OBJECTIVES: Estimating the risk of competing mortality is of importance in men with early prostate cancer in order to choose the most appropriate way of management and to avoid overor undertreatment. We investigated the association the level of education with different causes of death after radical prostatectomy. METHODS: The study sample consisted of 2630 patients with complete data on level of education (college or university degree or master craftsmen or comparable profession versus others), histopathological tumor stage (organ confined versus extracapsular), lymph node status (negative versus positive) and prostatectomy specimen Gleason score (<7 versus 7 versus 8-10) who underwent radical prostatectomy between 1992 and 2007. Overall, prostate cancer-specific, competing and second cancer-related mortality were study endpoints. Cox proportional hazard models for competing risks were used to study combined effects of the variables on these endpoints. RESULTS: A higher level of education was independently associated with decreased overall mortality after radical prostatectomy (hazard ratio, HR, 0.75, 95% confidence interval, CI, 0.62-0.91, p1⁄40.0037). The mortality difference was attributable to decreased second cancer mortality (HR 0.59, 95% CI 0.40-0.85, p1⁄40.0052) and non-cancer mortality (HR 0.73, 95% CI 0.55-0.98, p1⁄40.0345) but not to differences in prostate cancer-specific mortality (HR 1.16, 95% CI 0.791.69, p1⁄40.4536 in the full model). CONCLUSIONS: The level of education might serve as an independent prognostic parameter supplementary to age, comorbidity and smoking status in order to estimate the risk of competing mortality and to choose optimal treatment for men with early prostate cancer who are candidates for radical prostatectomy.