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Tytuł pozycji:

A critical assessment of the value of lymph node dissection at radical prostatectomy: A population-based study.

Tytuł:
A critical assessment of the value of lymph node dissection at radical prostatectomy: A population-based study.
Autorzy:
Abdollah F; Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada; Department of Urology, Vita Salute San Raffaele University, Milan, Italy. .
Schmitges J
Sun M
Tian Z
Briganti A
Shariat SF
Perrotte P
Montorsi F
Karakiewicz PI
Źródło:
The Prostate [Prostate] 2011 Oct 01; Vol. 71 (14), pp. 1587-94. Date of Electronic Publication: 2011 Apr 07.
Typ publikacji:
Journal Article; Research Support, Non-U.S. Gov't
Język:
English
Imprint Name(s):
Publication: <2005-> : Hoboken, NJ : Wiley-Liss
Original Publication: New York : Alan R. Liss, c1980-
MeSH Terms:
Adenocarcinoma*/mortality
Adenocarcinoma*/secondary
Adenocarcinoma*/surgery
Prostatic Neoplasms*/mortality
Prostatic Neoplasms*/pathology
Prostatic Neoplasms*/surgery
Lymph Node Excision/*mortality
Prostatectomy/*mortality
Adult ; Aged ; Aged, 80 and over ; Humans ; Kaplan-Meier Estimate ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Grading ; Predictive Value of Tests ; Proportional Hazards Models ; Prostatectomy/methods ; Risk Factors ; SEER Program
Contributed Indexing:
Keywords: lymph node excision; neoplasms/pathology; prostatic neoplasms/surgery
Entry Date(s):
Date Created: 20110412 Date Completed: 20150109 Latest Revision: 20141103
Update Code:
20240104
DOI:
10.1002/pros.21376
PMID:
21480307
Czasopismo naukowe
Objective: We tested relationship between pelvic lymph node dissection (PLND) status at the time of radical prostatectomy (RP) and survival in prostate cancer (PCa) patients.
Methods: Overall, 127,824 PCa patients treated with RP between 1988 and 2006 were included. Univariable and multivariable Cox regression analyses were used to evaluate the impact of PLND status (pN0 vs. pNx vs. pN1) on cancer-specific mortality (CSM) and overall mortality (OM) rates.
Results: In pT2 patients, the 5-, 10-, and 15-year CSM rates were: 0.4%, 1.7%, and 3.9% for pN0, 0.6%, 2.5%, and 4.7% for pNx, 2.7%, 11.9%, and 20.6% for pN1 patients (all P < 0.001). The 5-, 10-, and 15-year OM rates were: 5.4%, 16.3%, and 34.5% for pN0, 6.1%, 18.2%, and 35.3% for pNx, 11.5%, 32.7%, and 53.4% for pN1 (all P < 0.001). In multivariable analyses, pNx and pN1 stage increased CSM rate, respectively by 1.3- and 3.8-fold (both P < 0.001) relative to pN0. Similarly, pNx and pN1 increased OM rate respectively by 1.1- and 1.6-fold (both P < 0.001) relative to pN0. In pT3 patients, pNx stage did not significantly increase CSM or OM rates relative to pN0 (both P > 0.05).
Conclusions: Patients with localized PCa treated with RP without a PLND (pNx) have less favorable survival rate than their counterparts that do not harbor lymph node invasion at PLND. However, the difference is modest (0.8% at 10 years). In consequence, the related costs and benefits of this procedure should be weighted carefully. In addition, the survival benefit of PLND was not observed in locally advanced PCa patients.
(Copyright © 2011 Wiley-Liss, Inc.)

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