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Marked Prognostic Impact of Minimal Lymphatic Tumor Spread in Prostate Cancer

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Marked Prognostic Impact of Minimal Lymphatic Tumor Spread in Prostate Cancer. / Wilczak, Waldemar; Wittmer, Corinna; Clauditz, Till; Minner, Sarah; Steurer, Stefan; Büscheck, Franziska; Krech, Till; Lennartz, Maximilian; Harms, Luisa; Leleu, Diane; Ahrens, Marc; Ingwerth, Sebastian; Günther, Christian T; Koop, Christina; Simon, Ronald; Jacobsen, Frank; Tsourlakis, Maria C; Chirico, Viktoria; Höflmayer, Doris; Vettorazzi, Eik; Haese, Alexander; Steuber, Thomas; Salomon, Georg; Michl, Uwe; Budäus, Lars; Tilki, Derya; Thederan, Imke; Fraune, Christoph; Göbel, Cosima; Henrich, Marie-Christine; Juhnke, Manuela; Möller, Katharina; Bawahab, Ahmed Abdullah; Uhlig, Ria; Adam, Meike; Weidemann, Sören; Beyer, Burkhard; Huland, Hartwig; Graefen, Markus; Sauter, Guido; Schlomm, Thorsten.

In: EUR UROL, Vol. 74, No. 3, 09.2018, p. 376-386.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Wilczak, W, Wittmer, C, Clauditz, T, Minner, S, Steurer, S, Büscheck, F, Krech, T, Lennartz, M, Harms, L, Leleu, D, Ahrens, M, Ingwerth, S, Günther, CT, Koop, C, Simon, R, Jacobsen, F, Tsourlakis, MC, Chirico, V, Höflmayer, D, Vettorazzi, E, Haese, A, Steuber, T, Salomon, G, Michl, U, Budäus, L, Tilki, D, Thederan, I, Fraune, C, Göbel, C, Henrich, M-C, Juhnke, M, Möller, K, Bawahab, AA, Uhlig, R, Adam, M, Weidemann, S, Beyer, B, Huland, H, Graefen, M, Sauter, G & Schlomm, T 2018, 'Marked Prognostic Impact of Minimal Lymphatic Tumor Spread in Prostate Cancer', EUR UROL, vol. 74, no. 3, pp. 376-386. https://doi.org/10.1016/j.eururo.2018.05.034

APA

Wilczak, W., Wittmer, C., Clauditz, T., Minner, S., Steurer, S., Büscheck, F., Krech, T., Lennartz, M., Harms, L., Leleu, D., Ahrens, M., Ingwerth, S., Günther, C. T., Koop, C., Simon, R., Jacobsen, F., Tsourlakis, M. C., Chirico, V., Höflmayer, D., ... Schlomm, T. (2018). Marked Prognostic Impact of Minimal Lymphatic Tumor Spread in Prostate Cancer. EUR UROL, 74(3), 376-386. https://doi.org/10.1016/j.eururo.2018.05.034

Vancouver

Wilczak W, Wittmer C, Clauditz T, Minner S, Steurer S, Büscheck F et al. Marked Prognostic Impact of Minimal Lymphatic Tumor Spread in Prostate Cancer. EUR UROL. 2018 Sep;74(3):376-386. https://doi.org/10.1016/j.eururo.2018.05.034

Bibtex

@article{94cf824e4bdc4cf390a24dc90ce33293,
title = "Marked Prognostic Impact of Minimal Lymphatic Tumor Spread in Prostate Cancer",
abstract = "BACKGROUND: Nodal metastasis (N1) is a strong prognostic parameter in prostate cancer; however, lymph node evaluation is always incomplete.OBJECTIVE: To study the prognostic value of lymphatic invasion (L1) and whether it might complement or even replace lymph node analysis in clinical practice.DESIGN, SETTING, AND PARTICIPANTS: Retrospective analysis of pathological and clinical data from 14 528 consecutive patients.INTERVENTION: Radical prostatectomy.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The impact of L1 and N1 on patient prognosis was measured with time to biochemical recurrence as the primary endpoint.RESULTS AND LIMITATIONS: Nodal metastases were found in 1602 (12%) of 13 070 patients with lymph node dissection. L1 was seen in 2027 of 14 528 patients (14%) for whom lymphatic vessels had been visualized by immunohistochemistry. N1 and L1 continuously increased with unfavorable Gleason grade, advanced pT stage, and preoperative prostate-specific antigen (PSA) values (p<0.0001 each). N1 was found in 4.3% of 12 501 L0 and in 41% of 2027 L1 carcinomas (p<0.0001). L1 was seen in 11% of 9868 N0 and in 61% of 1360 N1 carcinomas (p<0.0001). Both N1 and L1 were linked to PSA recurrence (p<0.0001 each). This was also true for 17 patients with isolated tumor cells (ie, <200 unequivocal cancer cells without invasive growth) and 193 metastases ≤1mm. Combined analysis of N and L status showed that L1 had no prognostic effect in N1 patients but L1 was strikingly linked to PSA recurrence in N0 patients. N0L1 patients showed a similar outcome as N1 patients.CONCLUSIONS: Analysis of lymphatic invasion provides comparable prognostic information than lymph node analysis. Even minimal involvement of the lymphatic system has pivotal prognostic impact in prostate cancer. Thus, a thorough search for lymphatic involvement helps to identify more patients with an increased risk for disease recurrence.PATIENT SUMMARY: Already minimal amounts of tumor cells inside the lymph nodes or intraprostatic lymphatic vessels have a severe impact on patient prognosis.",
keywords = "Journal Article",
author = "Waldemar Wilczak and Corinna Wittmer and Till Clauditz and Sarah Minner and Stefan Steurer and Franziska B{\"u}scheck and Till Krech and Maximilian Lennartz and Luisa Harms and Diane Leleu and Marc Ahrens and Sebastian Ingwerth and G{\"u}nther, {Christian T} and Christina Koop and Ronald Simon and Frank Jacobsen and Tsourlakis, {Maria C} and Viktoria Chirico and Doris H{\"o}flmayer and Eik Vettorazzi and Alexander Haese and Thomas Steuber and Georg Salomon and Uwe Michl and Lars Bud{\"a}us and Derya Tilki and Imke Thederan and Christoph Fraune and Cosima G{\"o}bel and Marie-Christine Henrich and Manuela Juhnke and Katharina M{\"o}ller and Bawahab, {Ahmed Abdullah} and Ria Uhlig and Meike Adam and S{\"o}ren Weidemann and Burkhard Beyer and Hartwig Huland and Markus Graefen and Guido Sauter and Thorsten Schlomm",
note = "Copyright {\textcopyright} 2018 European Association of Urology. Published by Elsevier B.V. All rights reserved.",
year = "2018",
month = sep,
doi = "10.1016/j.eururo.2018.05.034",
language = "English",
volume = "74",
pages = "376--386",
journal = "EUR UROL",
issn = "0302-2838",
publisher = "Elsevier",
number = "3",

}

RIS

TY - JOUR

T1 - Marked Prognostic Impact of Minimal Lymphatic Tumor Spread in Prostate Cancer

AU - Wilczak, Waldemar

AU - Wittmer, Corinna

AU - Clauditz, Till

AU - Minner, Sarah

AU - Steurer, Stefan

AU - Büscheck, Franziska

AU - Krech, Till

AU - Lennartz, Maximilian

AU - Harms, Luisa

AU - Leleu, Diane

AU - Ahrens, Marc

AU - Ingwerth, Sebastian

AU - Günther, Christian T

AU - Koop, Christina

AU - Simon, Ronald

AU - Jacobsen, Frank

AU - Tsourlakis, Maria C

AU - Chirico, Viktoria

AU - Höflmayer, Doris

AU - Vettorazzi, Eik

AU - Haese, Alexander

AU - Steuber, Thomas

AU - Salomon, Georg

AU - Michl, Uwe

AU - Budäus, Lars

AU - Tilki, Derya

AU - Thederan, Imke

AU - Fraune, Christoph

AU - Göbel, Cosima

AU - Henrich, Marie-Christine

AU - Juhnke, Manuela

AU - Möller, Katharina

AU - Bawahab, Ahmed Abdullah

AU - Uhlig, Ria

AU - Adam, Meike

AU - Weidemann, Sören

AU - Beyer, Burkhard

AU - Huland, Hartwig

AU - Graefen, Markus

AU - Sauter, Guido

AU - Schlomm, Thorsten

N1 - Copyright © 2018 European Association of Urology. Published by Elsevier B.V. All rights reserved.

PY - 2018/9

Y1 - 2018/9

N2 - BACKGROUND: Nodal metastasis (N1) is a strong prognostic parameter in prostate cancer; however, lymph node evaluation is always incomplete.OBJECTIVE: To study the prognostic value of lymphatic invasion (L1) and whether it might complement or even replace lymph node analysis in clinical practice.DESIGN, SETTING, AND PARTICIPANTS: Retrospective analysis of pathological and clinical data from 14 528 consecutive patients.INTERVENTION: Radical prostatectomy.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The impact of L1 and N1 on patient prognosis was measured with time to biochemical recurrence as the primary endpoint.RESULTS AND LIMITATIONS: Nodal metastases were found in 1602 (12%) of 13 070 patients with lymph node dissection. L1 was seen in 2027 of 14 528 patients (14%) for whom lymphatic vessels had been visualized by immunohistochemistry. N1 and L1 continuously increased with unfavorable Gleason grade, advanced pT stage, and preoperative prostate-specific antigen (PSA) values (p<0.0001 each). N1 was found in 4.3% of 12 501 L0 and in 41% of 2027 L1 carcinomas (p<0.0001). L1 was seen in 11% of 9868 N0 and in 61% of 1360 N1 carcinomas (p<0.0001). Both N1 and L1 were linked to PSA recurrence (p<0.0001 each). This was also true for 17 patients with isolated tumor cells (ie, <200 unequivocal cancer cells without invasive growth) and 193 metastases ≤1mm. Combined analysis of N and L status showed that L1 had no prognostic effect in N1 patients but L1 was strikingly linked to PSA recurrence in N0 patients. N0L1 patients showed a similar outcome as N1 patients.CONCLUSIONS: Analysis of lymphatic invasion provides comparable prognostic information than lymph node analysis. Even minimal involvement of the lymphatic system has pivotal prognostic impact in prostate cancer. Thus, a thorough search for lymphatic involvement helps to identify more patients with an increased risk for disease recurrence.PATIENT SUMMARY: Already minimal amounts of tumor cells inside the lymph nodes or intraprostatic lymphatic vessels have a severe impact on patient prognosis.

AB - BACKGROUND: Nodal metastasis (N1) is a strong prognostic parameter in prostate cancer; however, lymph node evaluation is always incomplete.OBJECTIVE: To study the prognostic value of lymphatic invasion (L1) and whether it might complement or even replace lymph node analysis in clinical practice.DESIGN, SETTING, AND PARTICIPANTS: Retrospective analysis of pathological and clinical data from 14 528 consecutive patients.INTERVENTION: Radical prostatectomy.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The impact of L1 and N1 on patient prognosis was measured with time to biochemical recurrence as the primary endpoint.RESULTS AND LIMITATIONS: Nodal metastases were found in 1602 (12%) of 13 070 patients with lymph node dissection. L1 was seen in 2027 of 14 528 patients (14%) for whom lymphatic vessels had been visualized by immunohistochemistry. N1 and L1 continuously increased with unfavorable Gleason grade, advanced pT stage, and preoperative prostate-specific antigen (PSA) values (p<0.0001 each). N1 was found in 4.3% of 12 501 L0 and in 41% of 2027 L1 carcinomas (p<0.0001). L1 was seen in 11% of 9868 N0 and in 61% of 1360 N1 carcinomas (p<0.0001). Both N1 and L1 were linked to PSA recurrence (p<0.0001 each). This was also true for 17 patients with isolated tumor cells (ie, <200 unequivocal cancer cells without invasive growth) and 193 metastases ≤1mm. Combined analysis of N and L status showed that L1 had no prognostic effect in N1 patients but L1 was strikingly linked to PSA recurrence in N0 patients. N0L1 patients showed a similar outcome as N1 patients.CONCLUSIONS: Analysis of lymphatic invasion provides comparable prognostic information than lymph node analysis. Even minimal involvement of the lymphatic system has pivotal prognostic impact in prostate cancer. Thus, a thorough search for lymphatic involvement helps to identify more patients with an increased risk for disease recurrence.PATIENT SUMMARY: Already minimal amounts of tumor cells inside the lymph nodes or intraprostatic lymphatic vessels have a severe impact on patient prognosis.

KW - Journal Article

U2 - 10.1016/j.eururo.2018.05.034

DO - 10.1016/j.eururo.2018.05.034

M3 - SCORING: Journal article

C2 - 29908878

VL - 74

SP - 376

EP - 386

JO - EUR UROL

JF - EUR UROL

SN - 0302-2838

IS - 3

ER -