PROGNOSITC FACTORS OF NODAL METASTASIS IN PATIENTS WITH ORGAN CONFINED PROSTATE CANCER
To evaluate prognostic factors of nodal metastasis in patients affected by organ confined prostate cancer (PCa) who underwent laparoscopic radical prostatectomy (LPR).
Materials and Methods
From database of our institution, we identified patients undergone a laparoscopic pelvic lymphadenectomy (LAD) and radical prostatectomy; data on age, BMI, PSA, PSAD, positive cores percentage, clinical stage, Gleason score, lymphadenectomy template, prostate volume, number of removed nodes were available. We correlated these variables with pathological node metastasis by logistic regression analysis (SPSS 24).
Data on 183 patients were analyzed. Baseline characteristics are reported in table 1. On univariate analysis, PSA, PSAD, prostate volume, biopsy Gleason score were associated with pN1. Surgical and pathological outcomes are reported in table 2. At univariate analysis, pathological stage, positive surgical margins and LAD template (obturator and external vs obturator, external hypogastric and common) correlated with pN1. At multivariate analysis, PSAD and superextended lymphadenectomy were associated with nodal metastasis.
In our experience, nodal metastasis were present in 6.5% of patients despite a considerable average number of nodes removed. This results is probably due to a not high risk of nodal metastasis of our population. At multivariate analysis PSA density and lymphadenectomy template correlates with nodal metastasis. This evidence affirms need of an extended template during radical prostatectomy.
In our retrospective analysis, PSA density and superextended lymphadenectomy are prognostic factors of nodal metastasis.
Tumori Journal 2016, DOI:10.5301/tj.5000546
Urologia 2015 DOI:10.5301/uro.5000139Argomenti: cancro della prostata