More Extensive Lymph Node Dissection Tied to Better Prostate CA Survival

By Reuters Staff

December 28, 2015

NEW YORK (Reuters Health) - More extensive pelvic lymph node dissection (PLND) at the time of radical prostatectomy is associated with higher survival rates in men with locally advanced prostate cancer, according to a database study.

Several retrospective studies have yielded conflicting results regarding the possible benefits of meticulous PLND and no therapeutic impact has been shown in patients with advanced local stage, researchers say.

Dr. Alberto Briganti from IRCCS Ospedale San Raffaele in Milan, Italy, and colleagues investigated the relationship between the number of removed lymph nodes (RLN) and cancer-specific mortality in a retrospective study of 1,586 men with pT3-pT4 (locally advanced) prostate cancer treated with radical prostatectomy between 1987 and 2014.

A higher number of RLN independently predicted lower cancer-specific mortality rates in multivariable analyses, whereas higher numbers of positive lymph nodes independently predicted higher cancer-specific mortality.

The cancer-specific mortality-free rate increased from 93% for men with 10 RLN to 98% for men with 60 RLN, the researchers report in Prostate Cancer and Prostatic Diseases, online November 10.

Other factors independently associated with higher cancer-specific mortality included Gleason score 8-10 and treatment with adjuvant radiotherapy.

"Our results showed that, in prostate cancer patients with pathological advanced local stage, the removal of a higher number of nodes during radical prostatectomy was associated with an improvement in cancer-specific survival rate," the authors conclude. "This implies that an extensive PLND should be considered in all patients with a significant preoperative risk of harboring adverse pathological stage."

Dr. Briganti did not respond to a request for comments.


Prostate Cancer Prostatic Dis 2015.


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