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Long-term oncological outcomes in patients with limited nodal disease undergoing radical prostatectomy and pelvic lymph node dissection without adjuvant treatment

World Journal of Urology Aug 24, 2017

Mandel P, et al. – The physicians conducted this work to determine long–term oncologic outcomes in prostate cancer patients with limited nodal disease (1–2 positive lymph nodes) without adjuvant therapy after radical prostatectomy (RP). Evidence showd that patients with limited nodal disease (1–2 positive LNs) without adjuvant therapy displayed favourable CSS–rates above 94% after 5 years. In addition, subgroup of these patients (37%) remained metastasis–free without need of salvage treatment.

Methods
  • Researchers retrospectively examined data of 209 pN1 patients who underwent RP between January 1998 and 2010 with one (160) or two (49) histologically proven positive lymph nodes (LNs) without adjuvant treatment.
  • They reported biochemical recurrence–free survival, metastasis–free survival and cancer–specific survival (CSS).
  • In multivariable regression analyses further prognosticators of oncologic outcome in these patients were analysed.

Results
  • 60.2 months was the median follow– up.
  • No significant difference was found in oncologic outcome between patients with one and two positive LNs.
  • The data showed that 73.1% (76.7%) of patients with one (two) positive LNs had biochemical recurrence during the follow–up period, 20.0% (25.6%) developed metastasis and 8.1% (6.1%) died of their disease.
  • In addition, the only factors significantly correlated with oncologic outcome in multivariable analysis were Gleason score and pT–stage.
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