Cancer-Specific Mortality Differences in Specimen-Confined Radical Prostatectomy Patients According to Lymph Node Invasion
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Cancer-Specific Mortality Differences in Specimen-Confined Radical Prostatectomy Patients According to Lymph Node Invasion. / Barletta, Francesco; Tappero, Stefano; Morra, Simone; Incesu, Reha-Baris; Cano Garcia, Cristina; Piccinelli, Mattia Luca; Scheipner, Lukas; Baudo, Andrea; Tian, Zhe; Gandaglia, Giorgio; Stabile, Armando; Mazzone, Elio; Terrone, Carlo; Longo, Nicola; Tilki, Derya; Chun, Felix K H; de Cobelli, Ottavio; Ahyai, Sascha; Carmignani, Luca; Saad, Fred; Shariat, Shahrokh F; Montorsi, Francesco; Briganti, Alberto; Karakiewicz, Pierre I.
in: CLIN GENITOURIN CANC, Jahrgang 21, Nr. 6, 12.2023, S. e461-e466.e1.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Cancer-Specific Mortality Differences in Specimen-Confined Radical Prostatectomy Patients According to Lymph Node Invasion
AU - Barletta, Francesco
AU - Tappero, Stefano
AU - Morra, Simone
AU - Incesu, Reha-Baris
AU - Cano Garcia, Cristina
AU - Piccinelli, Mattia Luca
AU - Scheipner, Lukas
AU - Baudo, Andrea
AU - Tian, Zhe
AU - Gandaglia, Giorgio
AU - Stabile, Armando
AU - Mazzone, Elio
AU - Terrone, Carlo
AU - Longo, Nicola
AU - Tilki, Derya
AU - Chun, Felix K H
AU - de Cobelli, Ottavio
AU - Ahyai, Sascha
AU - Carmignani, Luca
AU - Saad, Fred
AU - Shariat, Shahrokh F
AU - Montorsi, Francesco
AU - Briganti, Alberto
AU - Karakiewicz, Pierre I
N1 - Copyright © 2023 Elsevier Inc. All rights reserved.
PY - 2023/12
Y1 - 2023/12
N2 - PURPOSE: To test cancer-specific mortality (CSM) differences in specimen-confined (pT2) prostate cancer (PCa) at radical prostatectomy (RP) with lymph node dissection (LND) according to lymph node invasion (LNI).METHODS: RP + LND pT2 PCa patients were identified (surveillance, epidemiology, and end results 2010-2015). CSM-FS rates were tested in Kaplan-Meier plots and multivariable Cox-regression (MCR) models. Sensitivity analyses respectively addressing patients with 6 or more lymph nodes analyzed and pT2 pN1 patients were performed.RESULTS: Overall, 32,258 patients with pT2 PCa at RP + LND were identified. Of these, 448 (1.4%) patients harbored LNI. Five-year CSM-free estimates were 99.6% for pN0 vs. 96.4% for pN1 (P < .001). In MCR models, pN1 (HR: 3.4, P < .001) independently predicted higher CSM. In sensitivity analyses addressing patients with 6 or more lymph nodes analyzed (n = 15,437), 328 (2.1%) pN1 patients were identified. In this subgroup, 5-year CSM-free estimates were 99.6% for pN0 vs. 96.3% for pN1 (P < .001) and, in MCR models, pN1 independently predicted higher CSM (HR: 4.4, P < .001). In sensitivity analyses addressing pT2 pN1 patients, 5-year CSM-free estimates were 99.3, 100 and 84.8% for ISUP GG 1-3 vs. 4 vs. 5, respectively (P < .001).CONCLUSIONS: In patients with pT2 PCa a small proportion harbor LNI (1.4%-2.1%). In such patients, CSM rate is higher (HR 3.4-4.4, P < .001). This higher CSM risk seems to virtually exclusively apply to ISUP GG5 patients (84.8% 5-year CSM-free rate).
AB - PURPOSE: To test cancer-specific mortality (CSM) differences in specimen-confined (pT2) prostate cancer (PCa) at radical prostatectomy (RP) with lymph node dissection (LND) according to lymph node invasion (LNI).METHODS: RP + LND pT2 PCa patients were identified (surveillance, epidemiology, and end results 2010-2015). CSM-FS rates were tested in Kaplan-Meier plots and multivariable Cox-regression (MCR) models. Sensitivity analyses respectively addressing patients with 6 or more lymph nodes analyzed and pT2 pN1 patients were performed.RESULTS: Overall, 32,258 patients with pT2 PCa at RP + LND were identified. Of these, 448 (1.4%) patients harbored LNI. Five-year CSM-free estimates were 99.6% for pN0 vs. 96.4% for pN1 (P < .001). In MCR models, pN1 (HR: 3.4, P < .001) independently predicted higher CSM. In sensitivity analyses addressing patients with 6 or more lymph nodes analyzed (n = 15,437), 328 (2.1%) pN1 patients were identified. In this subgroup, 5-year CSM-free estimates were 99.6% for pN0 vs. 96.3% for pN1 (P < .001) and, in MCR models, pN1 independently predicted higher CSM (HR: 4.4, P < .001). In sensitivity analyses addressing pT2 pN1 patients, 5-year CSM-free estimates were 99.3, 100 and 84.8% for ISUP GG 1-3 vs. 4 vs. 5, respectively (P < .001).CONCLUSIONS: In patients with pT2 PCa a small proportion harbor LNI (1.4%-2.1%). In such patients, CSM rate is higher (HR 3.4-4.4, P < .001). This higher CSM risk seems to virtually exclusively apply to ISUP GG5 patients (84.8% 5-year CSM-free rate).
KW - Male
KW - Humans
KW - Lymphatic Metastasis/pathology
KW - Lymph Nodes/surgery
KW - Lymph Node Excision/methods
KW - Prostate/pathology
KW - Prostatic Neoplasms/pathology
KW - Prostatectomy/methods
U2 - 10.1016/j.clgc.2023.05.010
DO - 10.1016/j.clgc.2023.05.010
M3 - SCORING: Journal article
C2 - 37365054
VL - 21
SP - e461-e466.e1
JO - CLIN GENITOURIN CANC
JF - CLIN GENITOURIN CANC
SN - 1558-7673
IS - 6
ER -