2019 ASCO GU Symposium

2019 ASCO GU Symposium

INTERVIEW WITH SUSAN HALABI
Racial Disparities in Prostate Cancer Treatment and Outcomes

VIEW ALL PROSTATE CANCER VIDEOS

2019 ASCO GU Symposium

2019 ASCO GU Symposium

INTERVIEW WITH MICHAEL HOFMAN
Theranostic Approaches for Advanced Prostate Cancer

VIEW ALL IMAGING: PROSTATE VIDEOS

2019 ASCO GU Symposium

2019 ASCO GU Symposium

INTERVIEW WITH KARIM FIZAZI
ARAMIS - Efficacy and Safety of Darolutamide in nmCRPC

VIEW ALL nmCRPC VIDEOS

2019 ASCO GU Symposium

2019 ASCO GU Symposium

INTERVIEW WITH MATTHEW GALSKY
Combination Approaches with Immune-Checkpoint Blockade in Bladder Cancer

VIEW ALL BLADDER CANCER VIDEOS

Featured Videos

#AUA14 - A more extensive pelvic lymph node dissection is associated with improved survival of patients with node-positive prostate cancer - Session Highlights

ORLANDO, FL USA (UroToday.com) - The association between the extent of pelvic lymph node dissection (PLND) and patient survival remains still unclear in prostate cancer. Only a few retrospective reports found an association between the extent of PLND and patient outcome. However, these studies are limited by the lack of standardized anatomical template of nodal dissection. The study group tested the association between the extent of nodal dissection and patient survival in a single-center cohort of node-positive patients treated with extended pelvic lymph node dissection (ePLND).

auaThe study included a total of 540 consecutive node-positive patients treated with radical prostatectomy (RP) and anatomically defined ePLND at a single European tertiary referral centre between 1992 and 2010. PLND consisted of removal of obturator, external iliac, hypogastric +/- pre-sacral and common iliac lymph nodes. Kaplan-Meier curves assessed time to cancer-specific and overall survival. Moreover, univariable and multivariable Cox regression analyses were performed to address predictors of cancer-specific and overall mortality. Covariates consisted of patient age and PSA at surgery, pathological Gleason sum, pathological stage, number of positive lymph nodes, number of lymph nodes removed, and adjuvant radiation and hormonal therapy.

The mean follow-up was 65 months (median: 63). Mean age at surgery was 65.5 years (median 66). Mean and median PSA at surgery was 26.6 and 11.5 ng/ml, respectively. Pathological stage was pT2, pT3a, pT3b and pT4 in 9.1%, 20%, 64.3% and 6.5% respectively. Pathological Gleason score 8-10 was present in 50.7% of patients. Mean and median number of lymph nodes removed were 21 and 19, respectively. Mean and median number of positive lymph nodes were 3.7 and 2, respectively. 39.8% and 84.4% of the patients received adjuvant radiotherapy, and hormonal therapy, respectively. The 8 and 10-year cancer specific and overall survival rates were 85 and 80%, and 73.4 and 70%. At multivariable analyses, after adjusting for all confounders, the number of lymph nodes removed was significantly inversely associated with both cancer-specific and overall mortality (p= 0.02; HR: 0.92 and p=0.01; 0.93, respectively). The number of positive lymph nodes, pathological Gleason score 8-10, and adjuvant RT were also significantly associated with patient survival (all p ≤ 0.02).

The authors conclude that in node-positive patients more extensive PLND is significantly associated with improved cancer-specific and overall survival rates. Therefore, in these patients, a meticulous PLND is advocated.

Presented by Firas Abdollah, MD at the American Urological Association (AUA) Annual Meeting - May 16 - 21, 2014 - Orlando, Florida USA

Milan, Italy

Written by Achim Lusch, MD, University of California (Irvine), and medical writer for UroToday.com

 

 

 

Conference Coverage
 
Recent data from conferences worldwide
Journals
Publications focusing on urologic cancer treatments through original manuscripts
Everyday Urology Volume 3 Issue 4

Everyday Urology™ - Oncology Insights

PCAN cover

Prostate Cancer and Prostatic Diseases

From the Editor

E-Newsletters

Newsletter subscription

Free Daily and Weekly newsletters offered by content of interest

The fields of GU Oncology and Urology are rapidly advancing. Sign up today for articles, videos, conference highlights and abstracts from peer-review publications by disease and condition delivered to your inbox and read on the go.

Subscribe