Lymph node yield during radical prostatectomy does not impact rate of biochemical recurrence in patients with seminal vesicle invasion and node-negative disease

Badani, Ketan K.; Reddy, Balaji; Moskowitz, Eric J.; Paulucci, David; Beksaç, Alp Tuna; Martini, Alberto; Whalen, Michael J.; Skarecky, Douglas; Huynh, Linda; Ahlering, Thomas E.

doi:10.1016/j.urolonc.2018.03.004

Cited by 9 publications

(4 citation statements)

References 33 publications

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“…For the population in the study, the 5-years BCR-free survival was 29.47%. These results are in line with those previously reported for pT3b patients (13.9% to 55.8%) [7,8,13,[17][18][19].…”

Section: Discussionsupporting

confidence: 93%

“…Similarly, Numbere et al [9] showed a better progression-free survival for the uni-SVI group, but no differences for cancer-specific mortality. Unlike these, neither Kristiansen et al [16] nor Badani et al [17] found differences among patients with uni-SVI and bi-SVI for progression and BCR, respectively. In our study, bi-SVI was not significantly associated with a higher risk of BCR [HR 1.18 (95%CI 0.77-1.91); p = 0.44].…”

Section: Discussionmentioning

confidence: 86%

“…We are not the first ones to report this kind of discordance for high-risk patients [18]. In fact, up to 25% of the patients were initially considered high-risk, downstaging at the final pathology [17].…”

Section: Discussionmentioning

confidence: 93%

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Bilateral Seminal Vesicle Invasion Is Not Associated with Worse Outcomes in Locally Advanced Prostate Carcinoma

et al. 2022

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Background and Objectives: Patients with seminal vesicle invasion (SVI) are a highly heterogeneous group. Prognosis can be affected by many clinical and pathological characteristics. Our aim was to study whether bilateral SVI (bi-SVI) is associated with worse oncological outcomes. Materials and Methods: This is an observational retrospective study that included 146 pT3b patients treated with radical prostatectomy (RP). We compared the results between unilateral SVI (uni-SVI) and bi-SVI. The log-rank test and Kaplan–Meier curves were used to compare biochemical recurrence-free survival (BCR), metastasis-free survival (MFS), and additional treatment-free survival. Cox proportional hazard models were used to identify predictors of BCR-free survival, MFS, and additional treatment-free survival. Results: 34.93% of patients had bi-SVI. The median follow-up was 46.84 months. No significant differences were seen between the uni-SVI and bi-SVI groups. BCR-free survival at 5 years was 33.31% and 25.65% (p = 0.44) for uni-SVI and bi-SVI. MFS at 5 years was 86.03% vs. 75.63% (p = 0.1), and additional treatment-free survival was 36.85% vs. 21.93% (p = 0.09), respectively. In the multivariate analysis, PSA was related to the development of BCR [HR 1.34 (95%CI: 1.01–1.77); p = 0.03] and metastasis [HR 1.83 (95%CI: 1.13–2.98); p = 0.02]. BCR was also influenced by lymph node infiltration [HR 2.74 (95%CI: 1.41–5.32); p = 0.003]. Additional treatment was performed more frequently in patients with positive margins [HR: 3.50 (95%CI: 1.65–7.44); p = 0.001]. Conclusions: SVI invasion is an adverse pathology feature, with a widely variable prognosis. In our study, bilateral seminal vesicle invasion did not predict worse outcomes in pT3b patients despite being associated with more undifferentiated tumors.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 86%

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Bilateral Seminal Vesicle Invasion Is Not Associated with Worse Outcomes in Locally Advanced Prostate Carcinoma

et al. 2022

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“…Many investigations have been carried out to determine if PLND should be put into practice. Badani et al conducted a retrospective analysis on the survival rates of patients with pT3b prostate cancer who underwent RP, revealing that the risk of postoperative biochemical recurrence was comparable between the two patient groups who did not undergo PLND and those who did; however, in patients who underwent PLND, the augmentation in the number of dissected lymph nodes did not significantly diminish the probability of biochemical recurrence [21]. Preisser et al 's study discovered that in a cohort of patients diagnosed with intermediate-risk and high-risk prostate cancer who were administered ePLND compared to those who were not, ePLND effectively furnished data regarding the classification of the tumor lymph nodes.…”

Section: Should Plnd Be Implemented?mentioning

confidence: 99%

The role and controversy of pelvic lymph node dissection in prostate cancer treatment: a focused review

Dong,

Zhan,

Luan

et al. 2024

World J Surg Onc

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Pelvic lymph node dissection (PLND) is commonly performed alongside radical prostatectomy. Its primary objective is to determine the lymphatic staging of prostate tumors by removing lymph nodes involved in lymphatic drainage. This aids in guiding subsequent treatment and removing metastatic foci, potentially offering significant therapeutic benefits. Despite varying recommendations from clinical practice guidelines across countries, the actual implementation of PLND is inconsistent, partly due to debates over its therapeutic value. While high-quality evidence supporting the superiority of PLND in oncological outcomes is lacking, its role in increasing surgical time and risk of complications is well-recognized. Despite these concerns, PLND remains the gold standard for lymph node staging in prostate cancer, providing invaluable staging information unattainable by other techniques. This article reviews PLND's scope, guideline perspectives, implementation status, oncologic and non-oncologic outcomes, alternatives, and future research needs.

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Impact of positive surgical margin status in predicting early biochemical recurrence after robot-assisted radical prostatectomy

et al. 2021

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Lymph node yield during radical prostatectomy does not impact rate of biochemical recurrence in patients with seminal vesicle invasion and node-negative disease

Cited by 9 publications

References 33 publications

Bilateral Seminal Vesicle Invasion Is Not Associated with Worse Outcomes in Locally Advanced Prostate Carcinoma

Bilateral Seminal Vesicle Invasion Is Not Associated with Worse Outcomes in Locally Advanced Prostate Carcinoma

The role and controversy of pelvic lymph node dissection in prostate cancer treatment: a focused review

Impact of positive surgical margin status in predicting early biochemical recurrence after robot-assisted radical prostatectomy

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