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Oncologic Outcomes of Lymph Node Dissection at Salvage Radical Prostatectomy

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Oncologic Outcomes of Lymph Node Dissection at Salvage Radical Prostatectomy. / Preisser, Felix; Incesu, Reha-Baris; Rajwa, Pawel; Chlosta, Marcin; Ahmed, Mohamed; Abreu, Andre Luis; Cacciamani, Giovanni; Ribeiro, Luis; Kretschmer, Alexander; Westhofen, Thilo; Smith, Joseph A; Graefen, Markus; Calleris, Giorgio; Raskin, Yannic; Gontero, Paolo; Joniau, Steven; Sanchez-Salas, Rafael; Shariat, Shahrokh F; Gill, Inderbir; Karnes, Robert Jeffrey; Cathcart, Paul; Van Der Poel, Henk; Marra, Giancarlo; Tilki, Derya.

In: CANCERS, Vol. 15, No. 12, 3123, 09.06.2023.

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

Harvard

Preisser, F, Incesu, R-B, Rajwa, P, Chlosta, M, Ahmed, M, Abreu, AL, Cacciamani, G, Ribeiro, L, Kretschmer, A, Westhofen, T, Smith, JA, Graefen, M, Calleris, G, Raskin, Y, Gontero, P, Joniau, S, Sanchez-Salas, R, Shariat, SF, Gill, I, Karnes, RJ, Cathcart, P, Van Der Poel, H, Marra, G & Tilki, D 2023, 'Oncologic Outcomes of Lymph Node Dissection at Salvage Radical Prostatectomy', CANCERS, vol. 15, no. 12, 3123. https://doi.org/10.3390/cancers15123123

APA

Preisser, F., Incesu, R-B., Rajwa, P., Chlosta, M., Ahmed, M., Abreu, A. L., Cacciamani, G., Ribeiro, L., Kretschmer, A., Westhofen, T., Smith, J. A., Graefen, M., Calleris, G., Raskin, Y., Gontero, P., Joniau, S., Sanchez-Salas, R., Shariat, S. F., Gill, I., ... Tilki, D. (2023). Oncologic Outcomes of Lymph Node Dissection at Salvage Radical Prostatectomy. CANCERS, 15(12), [3123]. https://doi.org/10.3390/cancers15123123

Vancouver

Preisser F, Incesu R-B, Rajwa P, Chlosta M, Ahmed M, Abreu AL et al. Oncologic Outcomes of Lymph Node Dissection at Salvage Radical Prostatectomy. CANCERS. 2023 Jun 9;15(12). 3123. https://doi.org/10.3390/cancers15123123

Bibtex

@article{ea3088b1792d443fb117beddcf646602,
title = "Oncologic Outcomes of Lymph Node Dissection at Salvage Radical Prostatectomy",
abstract = "BACKGROUND: Lymph node invasion (LNI) represents a poor prognostic factor after primary radical prostatectomy (RP) for prostate cancer (PCa). However, the impact of LNI on oncologic outcomes in salvage radical prostatectomy (SRP) patients is unknown.OBJECTIVE: To investigate the impact of lymph node dissection (LND) and pathological lymph node status (pNX vs. pN0 vs. pN1) on long-term oncologic outcomes of SRP patients.PATIENTS AND METHODS: Patients who underwent SRP for recurrent PCa between 2000 and 2021 were identified from 12 high-volume centers. Kaplan-Meier analyses and multivariable Cox regression models were used. Endpoints were biochemical recurrence (BCR), overall survival (OS), and cancer-specific survival (CSS).RESULTS: Of 853 SRP patients, 87% (n = 727) underwent LND, and 21% (n = 151) harbored LNI. The median follow-up was 27 months. The mean number of removed lymph nodes was 13 in the LND cohort. At 72 months after SRP, BCR-free survival was 54% vs. 47% vs. 7.2% for patients with pNX vs. pN0 vs. pN1 (p < 0.001), respectively. At 120 months after SRP, OS rates were 89% vs. 81% vs. 41% (p < 0.001), and CSS rates were 94% vs. 96% vs. 82% (p = 0.02) for patients with pNX vs. pN0 vs. pN1, respectively. In multivariable Cox regression analyses, pN1 status was independently associated with BCR (HR: 1.77, p < 0.001) and death (HR: 2.89, p < 0.001).CONCLUSIONS: In SRP patients, LNI represents an independent poor prognostic factor. However, the oncologic benefit of LND in SRP remains debatable. These findings underline the need for a cautious LND indication in SRP patients as well as strict postoperative monitoring of SRP patients with LNI.",
author = "Felix Preisser and Reha-Baris Incesu and Pawel Rajwa and Marcin Chlosta and Mohamed Ahmed and Abreu, {Andre Luis} and Giovanni Cacciamani and Luis Ribeiro and Alexander Kretschmer and Thilo Westhofen and Smith, {Joseph A} and Markus Graefen and Giorgio Calleris and Yannic Raskin and Paolo Gontero and Steven Joniau and Rafael Sanchez-Salas and Shariat, {Shahrokh F} and Inderbir Gill and Karnes, {Robert Jeffrey} and Paul Cathcart and {Van Der Poel}, Henk and Giancarlo Marra and Derya Tilki",
year = "2023",
month = jun,
day = "9",
doi = "10.3390/cancers15123123",
language = "English",
volume = "15",
journal = "CANCERS",
issn = "2072-6694",
publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",
number = "12",

}

RIS

TY - JOUR

T1 - Oncologic Outcomes of Lymph Node Dissection at Salvage Radical Prostatectomy

AU - Preisser, Felix

AU - Incesu, Reha-Baris

AU - Rajwa, Pawel

AU - Chlosta, Marcin

AU - Ahmed, Mohamed

AU - Abreu, Andre Luis

AU - Cacciamani, Giovanni

AU - Ribeiro, Luis

AU - Kretschmer, Alexander

AU - Westhofen, Thilo

AU - Smith, Joseph A

AU - Graefen, Markus

AU - Calleris, Giorgio

AU - Raskin, Yannic

AU - Gontero, Paolo

AU - Joniau, Steven

AU - Sanchez-Salas, Rafael

AU - Shariat, Shahrokh F

AU - Gill, Inderbir

AU - Karnes, Robert Jeffrey

AU - Cathcart, Paul

AU - Van Der Poel, Henk

AU - Marra, Giancarlo

AU - Tilki, Derya

PY - 2023/6/9

Y1 - 2023/6/9

N2 - BACKGROUND: Lymph node invasion (LNI) represents a poor prognostic factor after primary radical prostatectomy (RP) for prostate cancer (PCa). However, the impact of LNI on oncologic outcomes in salvage radical prostatectomy (SRP) patients is unknown.OBJECTIVE: To investigate the impact of lymph node dissection (LND) and pathological lymph node status (pNX vs. pN0 vs. pN1) on long-term oncologic outcomes of SRP patients.PATIENTS AND METHODS: Patients who underwent SRP for recurrent PCa between 2000 and 2021 were identified from 12 high-volume centers. Kaplan-Meier analyses and multivariable Cox regression models were used. Endpoints were biochemical recurrence (BCR), overall survival (OS), and cancer-specific survival (CSS).RESULTS: Of 853 SRP patients, 87% (n = 727) underwent LND, and 21% (n = 151) harbored LNI. The median follow-up was 27 months. The mean number of removed lymph nodes was 13 in the LND cohort. At 72 months after SRP, BCR-free survival was 54% vs. 47% vs. 7.2% for patients with pNX vs. pN0 vs. pN1 (p < 0.001), respectively. At 120 months after SRP, OS rates were 89% vs. 81% vs. 41% (p < 0.001), and CSS rates were 94% vs. 96% vs. 82% (p = 0.02) for patients with pNX vs. pN0 vs. pN1, respectively. In multivariable Cox regression analyses, pN1 status was independently associated with BCR (HR: 1.77, p < 0.001) and death (HR: 2.89, p < 0.001).CONCLUSIONS: In SRP patients, LNI represents an independent poor prognostic factor. However, the oncologic benefit of LND in SRP remains debatable. These findings underline the need for a cautious LND indication in SRP patients as well as strict postoperative monitoring of SRP patients with LNI.

AB - BACKGROUND: Lymph node invasion (LNI) represents a poor prognostic factor after primary radical prostatectomy (RP) for prostate cancer (PCa). However, the impact of LNI on oncologic outcomes in salvage radical prostatectomy (SRP) patients is unknown.OBJECTIVE: To investigate the impact of lymph node dissection (LND) and pathological lymph node status (pNX vs. pN0 vs. pN1) on long-term oncologic outcomes of SRP patients.PATIENTS AND METHODS: Patients who underwent SRP for recurrent PCa between 2000 and 2021 were identified from 12 high-volume centers. Kaplan-Meier analyses and multivariable Cox regression models were used. Endpoints were biochemical recurrence (BCR), overall survival (OS), and cancer-specific survival (CSS).RESULTS: Of 853 SRP patients, 87% (n = 727) underwent LND, and 21% (n = 151) harbored LNI. The median follow-up was 27 months. The mean number of removed lymph nodes was 13 in the LND cohort. At 72 months after SRP, BCR-free survival was 54% vs. 47% vs. 7.2% for patients with pNX vs. pN0 vs. pN1 (p < 0.001), respectively. At 120 months after SRP, OS rates were 89% vs. 81% vs. 41% (p < 0.001), and CSS rates were 94% vs. 96% vs. 82% (p = 0.02) for patients with pNX vs. pN0 vs. pN1, respectively. In multivariable Cox regression analyses, pN1 status was independently associated with BCR (HR: 1.77, p < 0.001) and death (HR: 2.89, p < 0.001).CONCLUSIONS: In SRP patients, LNI represents an independent poor prognostic factor. However, the oncologic benefit of LND in SRP remains debatable. These findings underline the need for a cautious LND indication in SRP patients as well as strict postoperative monitoring of SRP patients with LNI.

U2 - 10.3390/cancers15123123

DO - 10.3390/cancers15123123

M3 - SCORING: Journal article

C2 - 37370733

VL - 15

JO - CANCERS

JF - CANCERS

SN - 2072-6694

IS - 12

M1 - 3123

ER -