Post-radical prostatectomy (RP) lymph node positivity (pN1) is associated with disease progression. However, the optimal treatment strategy for pN1 patients has remained unclear. This study aimed to establish a risk model for predicting survival outcomes in these patients.
We retrospectively studied 528 eligible patients with pN1 undergoing RP with pelvic lymph node dissection between 2006 and 2019 at 33 participant institutions in the Japanese Urologic Oncology Study Group. Metastasis-free survival (MFS) was used to evaluate for survival outcome. A least absolute shrinkage and selection operator (LASSO)-penalized, multivariate Cox regression model for MFS was used to evaluate patients for their risk factors and establish a risk model with an associated nomogram.
Grade group (GGs 4-5 vs. GGs 1-3: HR, 7.35; 95% confidence intervals (CI), 1.76-30.7; p = 0.006), pathological T-stage (pT3b or more vs. pT2 to pT3a: HR, 2.01; 95% CI, 0.93-4.34; p = 0.075), number of positive lymph nodes (HR, 2.03; 95% CI, 0.83-4.96; p = 0.044), and positive lymph node diameter (> 2 mm vs. ≤ 2 mm: HR, 2.03; 95% CI, 1.09-9.00; p = 0.034) were identified as independent prognostic factors for predicting 60-month MFS.
This study explored prognostic factors for pN1 prostate cancer patients for predicting their MFS and identified a risk model involving a nomogram. Randomized controlled trials are necessary in patients with pN1 prostate cancer to elucidate optimal postoperative treatment indications and selection.
International journal of urology : official journal of the Japanese Urological Association. 2025 Jun 16 [Epub ahead of print]
Kojiro Tashiro, Keiichiro Mori, Masaki Shiota, Wataru Fukuokaya, Dai Takamatsu, Yoshiyuki Matsui, Masashi Kato, Ryoichi Saito, Akira Yokomizo, Masakazu Tsutsumi, Yoshiyuki Yamamoto, Kohei Edamura, Makito Miyake, Shuichi Morizane, Takayuki Yoshino, Ryuji Matsumoto, Shintaro Narita, Hiroshi Kitamura, Masatoshi Eto, Takahiro Kimura, Japanese Urological Oncology Group
Department of Urology, The Jikei University School of Medicine, Tokyo, Japan., Department of Urology, Kyushu University, Fukuoka, Japan., Department of Urology, National Cancer Center Hospital, Tokyo, Japan., Department of Urology, Nagoya University, Aichi, Japan., Department of Urology and Andrology, Kansai Medical University, Osaka, Japan., Department of Urology, Harasanshin Hospital, Japan Division of Urology, Fukuoka, Japan., Department of Urology, Hitachi General Hospital, Hitachi, Japan., Department of Urology, Osaka International Cancer Institute, Osaka, Japan., Department of Urology, Okayama University, Okayama, Japan., Department of Urology, Nara Medical University, Kashihara, Japan., Department of Urology, Faculty of Medicine, Tottori University, Yonago, Japan., Department of Urology, University of Tsukuba, Tsukuba, Japan., Department of Renal and Genitourinary Surgery, Hokkaido University, Japan Division of Urology, Sapporo, Japan., Department of Urology, Akita University Graduate School of Medicine, Akita, Japan., Department of Urology, University of Toyama, Toyama, Japan.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/40524484