San Diego, CA USA (UroToday.com) The therapeutic role of pelvic lymph node dissection (PLND) for prostate cancer (PCa) remains unclear in prostate cancer surgery literature.
Francis Ting and his research team from St Vincent’s Prostate Cancer Centre and The Kinghorn Cancer Centre in Australia sought to determine the correlation between the extent of PLND in lymph node (LN) negative PCa and the risk of subsequent biochemical recurrence (BCR).
The researchers performed retrospective analysis on all pT2-T4 N0 PCa patients who underwent radical prostatectomy (RP) with minimum 12 month follow-ups at their institution, from 1995 to 2012. 525 patents were analyzed and separated into two groups, one with 1-4 LNs retrieved during PLND (Group 1) and the other with equal to or greater than 5 LNs retrieved during PLND (Group 2). Group 1 consisted of 303 (58%) of the patients studied and Group 2 consisted of 222 (42%) of the patients studied. The average follow-up time was 71 months. The overall BCR rate determined was 19% with a median time to BCR of 31 months. Multivariate analysis showed a significant difference in BCR-free survival between Group 1 and Group 2, with Group 2 showing increased BCR-free survival. Additionally, multivariate analysis of PSA, pathological Gleason score (GS), and pathological stage showed independent and significant relationships with BCR.
The authors found that a more extensive PLND significantly increased BCR-free survival. They conclude that PLND may play a therapeutic role by removing micro-metastatic disease and urge physicians to consider more extensive PLND in PCa patients with significant preoperative risks of having LN invasion. When asked about the sample size, Ting replied that they are currently rerunning analysis on this data.
Presented By: Francis Ting, MD
Written By: Susan Li; Department of Urology, University of California, Irvine at the 2016 AUA Annual Meeting - May 6 - 10, 2016 – San Diego, California, USA