The long-term mortality risk from prostate cancer increases in lymph node (LN) positive patients.
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This study was done to assess the effect of lymph node Gleason score (LNGS) on prognosis in patients with LN-positive prostate cancer. Among the 1,415 patients who received pelvic lymph node dissection (PLND), 117 (8.4%) patients had a positive LN. The PGS of the prostate specimens and the LNGS of the positive LNs were assessed by uropathologists. The median age of patients at surgery was 67 years (interquartile range [IQR], 62-71 years) and the median follow-up duration was 44.3 months (IQR, 27.0-78.5 months). Pathologic Gleason scores (PGS) of 6-9 included one (0.9%), 53 (49.5%), 22 (20.6%), and 31 (29.0%) patients. The median total number of retrieved LNs was 9.0 (IQR, 5.3-12.8). The median number of positive LNs was one (IQR, 1-2). Cancer architecture with a Gleason pattern and score were observed in LNs as in ordinary prostate specimens. LNGS 6-9 included nine (8.1%), 57 (51.4%), 31 (27.9%), and 14 (12.6%) patients. The speaman's analysis showed the meaningful correlation between PGS and LNGS (P = 0.249, P = 0.011). The univariate analysis showed that the number of positive LNs and LNGS were significantly associated with prostate cancer-specific survival (P = 0.028; P = 0.005). The same architecture that is seen in the prostate was seen in positive LNs, and LNGS may be a significant prognostic factor in patients with LN-positive prostate cancer.
Ko K, Jeong IG, Choi WS, Lim JH, Suh JH, Ku JH, Park Y, Moon KC, Kim HH, Kim CS, Kwak C. Are you the author?
Department of Urology, Kandong Sacred Heart Hospital, Hallym University College of Medicine Seoul, Korea; Department of Urology, Asan Medical Center, Ulsan University College of Medicine Seoul, Korea; Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine Seoul, Korea; Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine Seoul, Korea; Department of Pathology, Asan Medical Center, Ulsan University College of Medicine Seoul, Korea.
Reference: Int J Clin Exp Pathol. 2014 Aug 15;7(9):6141-8.