Abstract
BackgroundThe aim of this study is to assess the prognosis of prostate cancer (PCa) with lymph node metastases (LNM) detected in pelvic lymph node dissection (PLND) after radical prostatectomy (RP) and adjuvant androgen deprivation therapy (ADT) in a Chinese population.MethodsFrom June 2005 to September 2012, the medical histories of 67 Chinese PCa patients with LNM detected after RP and extended PLND were collected, and all these patients received continuous adjuvant ADT. Postoperative survival was estimated using the Kaplan-Meier method. The impact of various clinicopathological factors on outcome was analyzed using Cox proportional hazard regression models. All tests were two-sided with P < 0.05 considered significant.ResultsMedian follow-up was 46.7 months, and two patients were lost to follow-up. Five-year event-free survival for patients with positive lymph nodes was 93.0%, 83.0%, and 96.0% for local recurrence, systemic progression, and cancer death, respectively. One-year, 2-year, and 3-year biochemical recurrence (BCR)-free survival was 52%, 40%, and 22%, respectively. Postoperative BCR-free survival was 25.7 months. BCR-free survival for patients with a single LNM was longer than those with two or more LNM (median 39.1 months vs. median 17.2 months, P = 0.002). In a multivariate Cox model, only two or more LNM was a significant predictor of BCR (hazard ratio 2.6, P = 0.005).ConclusionsDespite low BCR-free survival, Chinese patients with LNM can benefit from RP and adjuvant ADT. Patients with low nodal metastatic burden had a favorable prognosis.
Highlights
The aim of this study is to assess the prognosis of prostate cancer (PCa) with lymph node metastases (LNM) detected in pelvic lymph node dissection (PLND) after radical prostatectomy (RP) and adjuvant androgen deprivation therapy (ADT) in a Chinese population
We reviewed the medical records of 1,164 consecutive patients who underwent RP and extended PLND between June 2005 and September 2012 at our institute
At a median follow-up of 46.7 months, two patients were lost to follow-up, 43 patients had biochemical recurrence (BCR), five experienced local recurrence, seven had systemic relapse, and four died, including two from PCa
Summary
The aim of this study is to assess the prognosis of prostate cancer (PCa) with lymph node metastases (LNM) detected in pelvic lymph node dissection (PLND) after radical prostatectomy (RP) and adjuvant androgen deprivation therapy (ADT) in a Chinese population. An estimated 1.1 million men worldwide were diagnosed with PCa in 2012, accounting for 15% of all cancers diagnosed in men. In China, PCa incidence and Patients who undergo staging scans prior to surgery and have no radiological evidence of pelvic lymphadenopathy, but are subsequently found to have involved pelvic lymph nodes at the time of pelvic lymph node dissection (PLND), have pathologically lymph node metastases (LNM) and have a favorable prognosis [2,3,4].
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