Disease progression and survival in patients with prostate carcinoma and positive lymph nodes after radical retropubic prostatectomy

Abstract

pathological stage, number of positive lymph nodes and hormone therapy after RP. The statistical assessment included univariate regression analysis, and to analyse the distribution of clinical findings in different groups, Mantel-Haenszel statistics were used to test for differences in the numbers of patients. Survival and progression-free interval were assessed by Kaplan-Meier estimates and differences between groups calculated by log-rank statistics and Cox regression models. RESULTSThe median (range) follow-up was 55 (10-125) months. Adjuvant hormonal treatment was used in 77 patients, five of whom had immediate adjuvant radiotherapy, and nine delayed radiotherapy because of local progression or symptomatic bone metastases; five had no additional treatment. The rates for 5-and 10-year overall survival, clinical progression-free survival and biochemical progression-free survival were 84% and 79%, 83% and 77%, and 70% and 60%, respectively. Ten patients died (12%), eight (10%) of them from the cancer; bone metastases were detected in nine (11%). Local recurrences developed in three (4%) patients, 10 (12%) had a PSA increase of ≥ 0.4 ng/mL alone and 58 (71%) had no signs of progression, but two died from other causes. CONCLUSIONSMost patients with prostate cancer who had RP and pelvic lymphadenectomy followed by adjuvant hormone therapy, and who had lymph node metastases at the time of surgery, had excellent overall and progression-free survival in the long term.

Cancer Biomarker Discovery: The Entropic Hallmark

“…The biomarkers discussed in this section warrant further investigation in prediction of lymph-node metastasis and clinical management of prostate cancer [86], [87], [88], [89], [90], [91], [92], [93], [94], [95], [96], [97], [98], [99], [100], [101], [102], [103], [104], [105], [106], [107], [108], [109]. We refer the reader to the Supplementary Material to have a complete list of probes and their correlations with the Information Theory quantifiers.…”

Intraoperative frozen section assessment of pelvic lymph nodes during radical prostatectomy is of limited value

“…(1983) [11] 1975-81 10/13 13/42 Kramolowsky et al . (1984) [12] 1969 especially when supplemented with adjuvant hormone therapy, offer an excellent local control of the disease as well as overall and progression-free survival in the long term [16][17][18]. Considering these data, the concept of performing FS on PLNs may become irrelevant, as RP and PLND will be performed for both therapeutic as well as staging purposes regardless of the status of the PLNs during surgery.…”

Prognostic Significance of Positive Surgical Margins and Other Implications of Pathology Report

“…In the preadjuvant androgen deprivation therapy (ADT) era, 10-year PSA recurrence-free, clinical recurrence-free, and overall survival were 40, 69, and 74%, respectively, among 163 patients with N+ disease who received no adjuvant or neoadjuvant therapy. 104,105,[114][115][116] Boorjian et al observed that a single nodal metastasis had an approximately threefold significant increase in disease progression, and that ≥2 nodes imparted an additional twofold risk in a cohort of 507 node-positive patients of which the vast majority received adjuvant ADT. However, nodal metastases remain a poor prognostic factor with 10-year event-free survival for patients with positive VI.…”