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Incidence of positive pelvic lymph nodes in patients with prostate cancer, a prostate-specific antigen (PSA) level of < or =10 ng/mL and biopsy Gleason score of < or =6, and their influence on PSA progression-free survival after radical prostatectomy.
BJU Int. 2006 Jun; 97(6):1173-8.BI

Abstract

OBJECTIVE

To investigate how many men with low-risk prostate cancer had positive lymph nodes detected by radio-guided surgery and whether they had a higher biochemical relapse rate after radical prostatectomy, because in such patients most urologists dispense with operative lymph node staging, as nomograms indicate only a low percentage of lymph node metastases.

PATIENTS AND METHODS

The study included 474 men with a prostate-specific antigen (PSA) level of < or = 10 ng/mL, biopsy Gleason score of < or = 6 and positive biopsies in one (group 1, 315 men) or both lobes (group 2, 159 men); follow-up data were available in 357 men. Men with adjuvant radiation or hormone therapy before the occurrence of biochemical relapse were excluded.

RESULTS

Positive lymph nodes were detected in 17 men in group 1, and in 18 in group 2. In more than half of the patients (19/35) these nodes were found outside the region of standard lymphadenectomy. Men with node-positive disease had a higher biochemical relapse rate (P < 0.001). When the tumour was organ-confined and well differentiated in node-positive disease (Gleason score < or = 6) the biochemical relapse rate was lower than in men with higher tumour stage and grade.

CONCLUSIONS

When dissecting pelvic lymph nodes, extended or sentinel lymphadenectomy should be preferred. Removing the diseased nodes could improve the PSA progression-free survival, especially in well differentiated organ-confined disease.

Authors+Show Affiliations

Department of Urology, Klinikum Augsburg, Augsburg, Germany. dorothea.weckermann@uro.augsburg-med.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16686707

Citation

Weckermann, Dorothea, et al. "Incidence of Positive Pelvic Lymph Nodes in Patients With Prostate Cancer, a Prostate-specific Antigen (PSA) Level of < or =10 ng/mL and Biopsy Gleason Score of < or =6, and Their Influence On PSA Progression-free Survival After Radical Prostatectomy." BJU International, vol. 97, no. 6, 2006, pp. 1173-8.
Weckermann D, Goppelt M, Dorn R, et al. Incidence of positive pelvic lymph nodes in patients with prostate cancer, a prostate-specific antigen (PSA) level of < or =10 ng/mL and biopsy Gleason score of < or =6, and their influence on PSA progression-free survival after radical prostatectomy. BJU Int. 2006;97(6):1173-8.
Weckermann, D., Goppelt, M., Dorn, R., Wawroschek, F., & Harzmann, R. (2006). Incidence of positive pelvic lymph nodes in patients with prostate cancer, a prostate-specific antigen (PSA) level of < or =10 ng/mL and biopsy Gleason score of < or =6, and their influence on PSA progression-free survival after radical prostatectomy. BJU International, 97(6), 1173-8.
Weckermann D, et al. Incidence of Positive Pelvic Lymph Nodes in Patients With Prostate Cancer, a Prostate-specific Antigen (PSA) Level of < or =10 ng/mL and Biopsy Gleason Score of < or =6, and Their Influence On PSA Progression-free Survival After Radical Prostatectomy. BJU Int. 2006;97(6):1173-8. PubMed PMID: 16686707.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incidence of positive pelvic lymph nodes in patients with prostate cancer, a prostate-specific antigen (PSA) level of < or =10 ng/mL and biopsy Gleason score of < or =6, and their influence on PSA progression-free survival after radical prostatectomy. AU - Weckermann,Dorothea, AU - Goppelt,Marcus, AU - Dorn,Robert, AU - Wawroschek,Friedhelm, AU - Harzmann,Rolf, PY - 2006/5/12/pubmed PY - 2006/6/29/medline PY - 2006/5/12/entrez SP - 1173 EP - 8 JF - BJU international JO - BJU Int VL - 97 IS - 6 N2 - OBJECTIVE: To investigate how many men with low-risk prostate cancer had positive lymph nodes detected by radio-guided surgery and whether they had a higher biochemical relapse rate after radical prostatectomy, because in such patients most urologists dispense with operative lymph node staging, as nomograms indicate only a low percentage of lymph node metastases. PATIENTS AND METHODS: The study included 474 men with a prostate-specific antigen (PSA) level of < or = 10 ng/mL, biopsy Gleason score of < or = 6 and positive biopsies in one (group 1, 315 men) or both lobes (group 2, 159 men); follow-up data were available in 357 men. Men with adjuvant radiation or hormone therapy before the occurrence of biochemical relapse were excluded. RESULTS: Positive lymph nodes were detected in 17 men in group 1, and in 18 in group 2. In more than half of the patients (19/35) these nodes were found outside the region of standard lymphadenectomy. Men with node-positive disease had a higher biochemical relapse rate (P < 0.001). When the tumour was organ-confined and well differentiated in node-positive disease (Gleason score < or = 6) the biochemical relapse rate was lower than in men with higher tumour stage and grade. CONCLUSIONS: When dissecting pelvic lymph nodes, extended or sentinel lymphadenectomy should be preferred. Removing the diseased nodes could improve the PSA progression-free survival, especially in well differentiated organ-confined disease. SN - 1464-4096 UR - https://www.unboundmedicine.com/medline/citation/16686707/Incidence_of_positive_pelvic_lymph_nodes_in_patients_with_prostate_cancer_a_prostate_specific_antigen__PSA__level_of_<_or_=10_ng/mL_and_biopsy_Gleason_score_of_<_or_=6_and_their_influence_on_PSA_progression_free_survival_after_radical_prostatectomy_ L2 - https://doi.org/10.1111/j.1464-410X.2006.06166.x DB - PRIME DP - Unbound Medicine ER -