Abstract | OBJECTIVES: MATERIALS AND METHODS: A single institution cohort of 2,487 men with cT1-T2 CaP treated with open radical prostatectomy and pelvic lymph node dissection between 1988 and 2008 were analyzed. Kaplan-Meier and Cox proportional regression models were used to analyze overall survival (OS), clinical recurrence-free survival (cRFS), and biochemical recurrence-free survival (bRFS). RESULTS: Overall, 150 out of 2,487 patients (6%) had pN1 disease, with a median follow-up of 10.4 years. The predicted 10-year OS, cRFS, and bRFS rates for patients with pN0 and pN1 were 86% and 74% (Log rank P < 0.001), 97% and 84% (Log rank P < 0.001), and 88% and 57% (Log rank P < 0.001), respectively. In the subset of pN1 patients treated with surgery only (n = 49), the predicted 10-year OS, cRFS, and bRFS rates were 81%, 80%, and 59%, respectively. Exploratory univariate regression analysis showed that age (P = 0.003), total number of lymph nodes identified (P = 0.040), and total number of positive lymph nodes identified (P = 0.004) were associated with OS. Total number of positive lymph nodes (LNs) identified was also significantly associated with cRFS (P = 0.05). CONCLUSIONS: The incidence of pN1 in patients with cT1-T2 CaP treated with surgery in the era of PSA screening was low. RP and PLND demonstrated therapeutic efficacy in a subset of pN1 patients treated with surgery alone.
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Authors | Ryan P Dorin, Gary Lieskovsky, Adrian S Fairey, Jie Cai, Siamak Daneshmand |
Journal | Urologic oncology
(Urol Oncol)
Vol. 31
Issue 8
Pg. 1441-7
(Nov 2013)
ISSN: 1873-2496 [Electronic] United States |
PMID | 22516714
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2013 Elsevier Inc. All rights reserved. |
Chemical References |
- Prostate-Specific Antigen
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Topics |
- Aged
- Follow-Up Studies
- Humans
- Kaplan-Meier Estimate
- Lymph Node Excision
(methods)
- Lymph Nodes
(pathology, surgery)
- Lymphatic Metastasis
- Male
- Middle Aged
- Multivariate Analysis
- Neoplasm Staging
- Outcome Assessment, Health Care
(statistics & numerical data)
- Pelvis
- Proportional Hazards Models
- Prostate-Specific Antigen
(blood)
- Prostatectomy
(methods)
- Prostatic Neoplasms
(blood, pathology, surgery)
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