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No difference in six-year biochemical failure rates with or without pelvic lymph node dissection during radical prostatectomy in low-risk patients with localized prostate cancer.
Urology. 2004 Mar; 63(3):528-31.U

Abstract

OBJECTIVES

To compare differences in the actuarial biochemical relapse-free survival rates at 6 years in a contemporary series of patients who underwent radical prostatectomy with and without pelvic lymph node dissection (PLND). Biochemical failure was defined as a serum prostate-specific antigen level greater than 0.2 ng/mL confirmed at least 1 week later.

METHODS

The records of 806 consecutive radical prostatectomy cases performed between January 1995 and June 1999 were reviewed. A total of 336 patients with favorable tumor characteristics (prostate-specific antigen 10 ng/mL or less, biopsy Gleason score 6 or less, and clinical Stage T1 or T2) not receiving adjuvant or neoadjuvant therapy were divided into two groups according to whether PLND was performed (PLND group, n = 140) or omitted (no-PLND group, n = 196). A Cox proportional hazards model was used to analyze the effect of age, race, family history, initial prostate-specific antigen level, tumor stage, biopsy Gleason score, PLND, extracapsular extension, and seminal vesicle invasion on the likelihood of biochemical failure. Biochemical relapse-free survival for each group was estimated by Kaplan-Meier analysis. The mean follow-up time for the entire group was 60.0 months, with a similar follow-up for both cohorts (mean 61.8 and 58.2 months, respectively, P value not statistically significant). Follow-up information was obtained through an institutional review board-approved prospective patient registry.

RESULTS

The 6-year biochemical relapse-free rate for the PLND versus no-PLND group was 86% and 88%, respectively (P = 0.28). On multivariate analysis, PLND was not an independent predictor of outcome (P = 0.33).

CONCLUSIONS

Our study results demonstrated that the omission of PLND in patients with favorable tumor characteristics does not adversely affect biochemical relapse rates at 6 years after surgery. Such patients can be spared the morbidity and cost of PLND without affecting the chance for cure.

Authors+Show Affiliations

Bhatta-Dhar N
Glickman Urological Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Reuther AM
No affiliation info available
Zippe C
No affiliation info available
Klein EA
No affiliation info available

MeSH

AdenocarcinomaAgedBiomarkers, TumorCohort StudiesDisease-Free SurvivalFollow-Up StudiesHumansLife TablesLymph Node ExcisionLymphatic MetastasisMaleMiddle AgedNeoplasm ProteinsPelvisProstate-Specific AntigenProstatectomyProstatic NeoplasmsRetrospective StudiesRiskSurvival AnalysisTreatment OutcomeUnnecessary Procedures

Pub Type(s)

Comparative Study
Journal Article
Review

Language

eng

PubMed ID

15028451

Clinical Trial Links

Lymph Node Involvement Using Extended Pelvic Lymphadenectomy in Clinically Localized Prostate Cancer

Citation

Bhatta-Dhar, Nivedita, et al. "No Difference in Six-year Biochemical Failure Rates With or Without Pelvic Lymph Node Dissection During Radical Prostatectomy in Low-risk Patients With Localized Prostate Cancer." Urology, vol. 63, no. 3, 2004, pp. 528-31.
Bhatta-Dhar N, Reuther AM, Zippe C, et al. No difference in six-year biochemical failure rates with or without pelvic lymph node dissection during radical prostatectomy in low-risk patients with localized prostate cancer. Urology. 2004;63(3):528-31.
Bhatta-Dhar, N., Reuther, A. M., Zippe, C., & Klein, E. A. (2004). No difference in six-year biochemical failure rates with or without pelvic lymph node dissection during radical prostatectomy in low-risk patients with localized prostate cancer. Urology, 63(3), 528-31.
Bhatta-Dhar N, et al. No Difference in Six-year Biochemical Failure Rates With or Without Pelvic Lymph Node Dissection During Radical Prostatectomy in Low-risk Patients With Localized Prostate Cancer. Urology. 2004;63(3):528-31. PubMed PMID: 15028451.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - No difference in six-year biochemical failure rates with or without pelvic lymph node dissection during radical prostatectomy in low-risk patients with localized prostate cancer. AU - Bhatta-Dhar,Nivedita, AU - Reuther,Alwyn M, AU - Zippe,Craig, AU - Klein,Eric A, PY - 2003/08/05/received PY - 2003/09/26/accepted PY - 2004/3/19/pubmed PY - 2004/6/24/medline PY - 2004/3/19/entrez SP - 528 EP - 31 JF - Urology JO - Urology VL - 63 IS - 3 N2 - OBJECTIVES: To compare differences in the actuarial biochemical relapse-free survival rates at 6 years in a contemporary series of patients who underwent radical prostatectomy with and without pelvic lymph node dissection (PLND). Biochemical failure was defined as a serum prostate-specific antigen level greater than 0.2 ng/mL confirmed at least 1 week later. METHODS: The records of 806 consecutive radical prostatectomy cases performed between January 1995 and June 1999 were reviewed. A total of 336 patients with favorable tumor characteristics (prostate-specific antigen 10 ng/mL or less, biopsy Gleason score 6 or less, and clinical Stage T1 or T2) not receiving adjuvant or neoadjuvant therapy were divided into two groups according to whether PLND was performed (PLND group, n = 140) or omitted (no-PLND group, n = 196). A Cox proportional hazards model was used to analyze the effect of age, race, family history, initial prostate-specific antigen level, tumor stage, biopsy Gleason score, PLND, extracapsular extension, and seminal vesicle invasion on the likelihood of biochemical failure. Biochemical relapse-free survival for each group was estimated by Kaplan-Meier analysis. The mean follow-up time for the entire group was 60.0 months, with a similar follow-up for both cohorts (mean 61.8 and 58.2 months, respectively, P value not statistically significant). Follow-up information was obtained through an institutional review board-approved prospective patient registry. RESULTS: The 6-year biochemical relapse-free rate for the PLND versus no-PLND group was 86% and 88%, respectively (P = 0.28). On multivariate analysis, PLND was not an independent predictor of outcome (P = 0.33). CONCLUSIONS: Our study results demonstrated that the omission of PLND in patients with favorable tumor characteristics does not adversely affect biochemical relapse rates at 6 years after surgery. Such patients can be spared the morbidity and cost of PLND without affecting the chance for cure. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/15028451/No_difference_in_six_year_biochemical_failure_rates_with_or_without_pelvic_lymph_node_dissection_during_radical_prostatectomy_in_low_risk_patients_with_localized_prostate_cancer_ DB - PRIME DP - Unbound Medicine ER -