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Is pelvic lymph node dissection necessary in patients with a serum PSA<10ng/ml undergoing radical prostatectomy for prostate cancer?
Eur Urol. 2006 Aug; 50(2):272-9.EU

Abstract

OBJECTIVE

Controversy persists concerning the role of pelvic lymph node dissection (PLND) in patients with preoperative PSA values <10ng/ml undergoing treatment for prostate cancer with a curative intent. The aim of this study was to determine the incidence of lymph node metastasis in this subgroup of patients.

METHODS

Patients with clinically localized prostate cancer and a serum PSA<10ng/ml, without neoadjuvant hormonal or radiotherapy, with negative staging examinations who underwent radical retropubic prostatectomy with bilateral extended PLND and with >/=10 lymph nodes detected by the pathologist in the surgical specimen, were included in the study.

RESULTS

A total of 231 patients with a median serum PSA of 6.7ng/ml (range 0.4-9.98) and a median age of 62 years (range 44-76) were evaluated. A median of 20 (range 10-72) nodes were removed per patient. Positive nodes were found in 26 of 231 patients (11%), the majority of which (81%) had a Gleason score >/=7 in the surgical specimen. Of the patients with a Gleason score >/=7 in the prostatectomy specimen 25% had positive nodes, whereas only 3% with a Gleason score </=6 were node positive.

CONCLUSIONS

The incidence of positive nodes in patients with clinically localized prostate cancer, a serum PSA<10ng/ml and a Gleason score >/=7 in the prostatectomy specimen was 25% after extended PLND. It seems that in this patient group extended PLND, including removal of nodes along the internal iliac vessels, is warranted.

Authors+Show Affiliations

Department of Urology, University of Bern, Switzerland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16632187

Citation

Schumacher, Martin C., et al. "Is Pelvic Lymph Node Dissection Necessary in Patients With a Serum PSA<10ng/ml Undergoing Radical Prostatectomy for Prostate Cancer?" European Urology, vol. 50, no. 2, 2006, pp. 272-9.
Schumacher MC, Burkhard FC, Thalmann GN, et al. Is pelvic lymph node dissection necessary in patients with a serum PSA<10ng/ml undergoing radical prostatectomy for prostate cancer? Eur Urol. 2006;50(2):272-9.
Schumacher, M. C., Burkhard, F. C., Thalmann, G. N., Fleischmann, A., & Studer, U. E. (2006). Is pelvic lymph node dissection necessary in patients with a serum PSA<10ng/ml undergoing radical prostatectomy for prostate cancer? European Urology, 50(2), 272-9.
Schumacher MC, et al. Is Pelvic Lymph Node Dissection Necessary in Patients With a Serum PSA<10ng/ml Undergoing Radical Prostatectomy for Prostate Cancer. Eur Urol. 2006;50(2):272-9. PubMed PMID: 16632187.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is pelvic lymph node dissection necessary in patients with a serum PSA<10ng/ml undergoing radical prostatectomy for prostate cancer? AU - Schumacher,Martin C, AU - Burkhard,Fiona C, AU - Thalmann,George N, AU - Fleischmann,Achim, AU - Studer,Urs E, Y1 - 2006/02/28/ PY - 2005/08/18/received PY - 2006/01/23/accepted PY - 2006/4/25/pubmed PY - 2008/2/22/medline PY - 2006/4/25/entrez SP - 272 EP - 9 JF - European urology JO - Eur Urol VL - 50 IS - 2 N2 - OBJECTIVE: Controversy persists concerning the role of pelvic lymph node dissection (PLND) in patients with preoperative PSA values <10ng/ml undergoing treatment for prostate cancer with a curative intent. The aim of this study was to determine the incidence of lymph node metastasis in this subgroup of patients. METHODS: Patients with clinically localized prostate cancer and a serum PSA<10ng/ml, without neoadjuvant hormonal or radiotherapy, with negative staging examinations who underwent radical retropubic prostatectomy with bilateral extended PLND and with >/=10 lymph nodes detected by the pathologist in the surgical specimen, were included in the study. RESULTS: A total of 231 patients with a median serum PSA of 6.7ng/ml (range 0.4-9.98) and a median age of 62 years (range 44-76) were evaluated. A median of 20 (range 10-72) nodes were removed per patient. Positive nodes were found in 26 of 231 patients (11%), the majority of which (81%) had a Gleason score >/=7 in the surgical specimen. Of the patients with a Gleason score >/=7 in the prostatectomy specimen 25% had positive nodes, whereas only 3% with a Gleason score </=6 were node positive. CONCLUSIONS: The incidence of positive nodes in patients with clinically localized prostate cancer, a serum PSA<10ng/ml and a Gleason score >/=7 in the prostatectomy specimen was 25% after extended PLND. It seems that in this patient group extended PLND, including removal of nodes along the internal iliac vessels, is warranted. SN - 0302-2838 UR - https://www.unboundmedicine.com/medline/citation/16632187/Is_pelvic_lymph_node_dissection_necessary_in_patients_with_a_serum_PSA<10ng/ml_undergoing_radical_prostatectomy_for_prostate_cancer L2 - https://linkinghub.elsevier.com/retrieve/pii/S0302-2838(06)00206-5 DB - PRIME DP - Unbound Medicine ER -