Features and management of men with pN1 cM0 prostate cancer after radical prostatectomy and lymphadenectomy: a systematic review of population-based evidence
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Features and management of men with pN1 cM0 prostate cancer after radical prostatectomy and lymphadenectomy: a systematic review of population-based evidence. / Laine, Charles; Gandaglia, Giorgio; Valerio, Massimo; Heidegger, Isabel; Tsaur, Igor; Olivier, Jonathan; Ceci, Francesco; van den Bergh, Roderick C N; Kretschmer, Alexander; Thibault, Constance; Chiu, Peter K; Tilki, Derya; Kasivisvanathan, Veeru; Preisser, Felix; Zattoni, Fabio; Fankhauser, Christian; Kesch, Claudia; Puche-Sanz, Ignacio; Moschini, Marco; Pradere, Benjamin; Ploussard, Guillaume; Marra, Giancarlo; EAU-YAU Prostate Cancer Working Group.
in: CURR OPIN UROL, Jahrgang 32, Nr. 1, 01.01.2022, S. 69-84.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Features and management of men with pN1 cM0 prostate cancer after radical prostatectomy and lymphadenectomy: a systematic review of population-based evidence
AU - Laine, Charles
AU - Gandaglia, Giorgio
AU - Valerio, Massimo
AU - Heidegger, Isabel
AU - Tsaur, Igor
AU - Olivier, Jonathan
AU - Ceci, Francesco
AU - van den Bergh, Roderick C N
AU - Kretschmer, Alexander
AU - Thibault, Constance
AU - Chiu, Peter K
AU - Tilki, Derya
AU - Kasivisvanathan, Veeru
AU - Preisser, Felix
AU - Zattoni, Fabio
AU - Fankhauser, Christian
AU - Kesch, Claudia
AU - Puche-Sanz, Ignacio
AU - Moschini, Marco
AU - Pradere, Benjamin
AU - Ploussard, Guillaume
AU - Marra, Giancarlo
AU - EAU-YAU Prostate Cancer Working Group
N1 - Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2022/1/1
Y1 - 2022/1/1
N2 - PURPOSE OF REVIEW: To investigate the features and optimal management of pN+ cM0 prostate cancer (PCa) according to registry-based studies.RECENT FINDINGS: Up to 15% of PCa patients harbor lymph node invasion (pN+) at radical prostatectomy plus lymph node dissection. Nonetheless, the optimal management strategy in this setting is not well characterized.SUMMARY: We performed a systematic review including n = 13 studies. Management strategies comprised 13 536 men undergoing observation, 11 149 adjuvant androgen deprivation therapy (aADT), 7,075 adjuvant radiotherapy (aRT) +aADT and 705 aRT. Baseline features showed aggressive PCa in the majority of men. At a median follow-up ranging 48-134months, Cancer-related death was 5% and overall-mortality 16.6%. aADT and aRT alone had no cancer-specific survival or overall survival advantages over observation only and over not performing aRT, respectively. aADT plus aRT yielded a survival benefit compared to observation and aADT, which in one study, were limited to certain intermediate-risk categories. Age, Gleason, Charlson score, positive surgical margins, pathological stage, and positive nodes number, but not prostate specific antigen, were most relevant prognostic factors. Our work further confirmed pN+ PCa is a multifaceted disease and will help future research in defining its optimal management based on different risk categories to maximize survival and patient's quality of life.
AB - PURPOSE OF REVIEW: To investigate the features and optimal management of pN+ cM0 prostate cancer (PCa) according to registry-based studies.RECENT FINDINGS: Up to 15% of PCa patients harbor lymph node invasion (pN+) at radical prostatectomy plus lymph node dissection. Nonetheless, the optimal management strategy in this setting is not well characterized.SUMMARY: We performed a systematic review including n = 13 studies. Management strategies comprised 13 536 men undergoing observation, 11 149 adjuvant androgen deprivation therapy (aADT), 7,075 adjuvant radiotherapy (aRT) +aADT and 705 aRT. Baseline features showed aggressive PCa in the majority of men. At a median follow-up ranging 48-134months, Cancer-related death was 5% and overall-mortality 16.6%. aADT and aRT alone had no cancer-specific survival or overall survival advantages over observation only and over not performing aRT, respectively. aADT plus aRT yielded a survival benefit compared to observation and aADT, which in one study, were limited to certain intermediate-risk categories. Age, Gleason, Charlson score, positive surgical margins, pathological stage, and positive nodes number, but not prostate specific antigen, were most relevant prognostic factors. Our work further confirmed pN+ PCa is a multifaceted disease and will help future research in defining its optimal management based on different risk categories to maximize survival and patient's quality of life.
U2 - 10.1097/MOU.0000000000000946
DO - 10.1097/MOU.0000000000000946
M3 - SCORING: Journal article
C2 - 34812201
VL - 32
SP - 69
EP - 84
JO - CURR OPIN UROL
JF - CURR OPIN UROL
SN - 0963-0643
IS - 1
ER -
