MP69-04 SINGLE POSITIVE LYMPH NODE PROSTATE CANCER CAN BE SURGICALLY CURED IN SELECTIVE CASES

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy V1 Apr 2016MP69-04 SINGLE POSITIVE LYMPH NODE PROSTATE CANCER CAN BE SURGICALLY CURED IN SELECTIVE CASES Dae Keun Kim, Kyo Chul Koo, Ki Hong Kim, Ali Abdel Raheem, Byung Ha Chung, Young Deuk Choi, and Koon Ho Rha Dae Keun KimDae Keun Kim More articles by this author , Kyo Chul KooKyo Chul Koo More articles by this author , Ki Hong KimKi Hong Kim More articles by this author , Ali Abdel RaheemAli Abdel Raheem More articles by this author , Byung Ha ChungByung Ha Chung More articles by this author , Young Deuk ChoiYoung Deuk Choi More articles by this author , and Koon Ho RhaKoon Ho Rha More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1382AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To investigate the curability of pN1 prostate cancer (PCa) patients treated surgically without immediate adjuvant treatment. METHODS We analyzed the database of 2316 patients at our institution who underwent robot-assisted radical prostatectomy (RARP) /radical prostatectomy (RP) between July 2005 and November 2012. 87 patients with pN1 PCa and received no neoadjuvant and immediate adjuvant therapy were included in the study. Included pN1 PCa patients were followed up for median of 60 months. Biochemical recurrence (BCR)- free survival, metastasis-free survival, cancer specific survival (CSS), and overall survival (OS) rates are determined by using Kaplan-Meier analysis. Cox regression analysis was performed to investigate the impact of prostate-specific antigen (PSA) level, Gleason score, extraprostatic extension, seminal vesicle invasion, perineural invasion, lymphovascular invasion, positive surgical margin, tumor volume, early post-operative PSA (6 weeks), PSA nadir, lymph node yield, and number of pathologically positive lymph nodes on survival. RESULTS The 5-year OS rate of patients was 86.1%, while the CSS rate was 89.6%. The metastasis-free and BCR-free rates were 71% and 19.1%, respectively, and each was significantly correlated with the number of positive lymph nodes on log rank tests (p = 0.004 and p = 0.039, respectively). The presence of 2 or more pathologically positive LNs (HR: 2.20; 95% CI 1.30-3.72; p = 0.003) and a Gleason score more than or equal 8 (HR: 2.40; 95% CI: 1.32–4.38; p = 0.04) were significant negative predictors of BCR free survival on multivariable regression analysis. Furthermore, the presence of 2 or more positive lymph nodes (HR: 1.06; 95% CI 1.01-1.11; p = 0.029) were significant negative predictors of metastasis-free survival on multivariable regression analysis. Additionally, in the patients who had no BCR without adjuvant treatment 9 patients out of 10 (90%) had single positive LN and 5 patients out of 10 (50%) had Gleason score 7. Therefore, single positive LN, and Gleason scores less than or equal 7 have significantly low risk of disease progression. CONCLUSIONS pN1 PCa patients have heterogenous clinical courses. Patients with single positive LN, and Gleason scores less than or equal 7 have chance of surgical curability. Close observation with delayed adjuvant hormone therapy can be considered in these patients. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e899 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Dae Keun Kim More articles by this author Kyo Chul Koo More articles by this author Ki Hong Kim More articles by this author Ali Abdel Raheem More articles by this author Byung Ha Chung More articles by this author Young Deuk Choi More articles by this author Koon Ho Rha More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...