Can Pelvic Lymph Node Dissection in Prostate Cancer Patients with a 5% Briganti Nomogram Cut-off Value Provide an Oncological Benefit? A Large Multi-Institutional Cohort Study in Japan.

Autor:	Sugihara N; Department of Urology, Ehime University., Hashine K; Department of Urology, National Hospital Organization Shikoku Cancer Center., Yamashita N; Division of Epidemiology, National Hospital Organization Shikoku Cancer Center., Sakamoto M; Department of Urology, Ehime University., Terashita M; Department of Urology, Ehime University., Funaki K; Department of Urology, Ehime University., Saiki K; Department of Urology, Ehime University., Sawada T; Department of Urology, Ehime University., Kakuda T; Department of Urology, Ehime University., Nishimura K; Department of Urology, Ehime University., Fukumoto T; Department of Urology, Ehime University., Miura N; Department of Urology, Ehime University., Miyauchi Y; Department of Urology, Ehime University., Kikugawa T; Department of Urology, Ehime University., Saika T; Department of Urology, Ehime University.
Jazyk:	angličtina
Zdroj:	Acta medica Okayama [Acta Med Okayama] 2024 Aug; Vol. 78 (4), pp. 307-312.
DOI:	10.18926/AMO/67546
Abstrakt:	The Briganti nomogram (cut-off value 5%) is commonly used to determine the indications for pelvic lymph node dissection (PLND) in patients with prostate cancer. We retrospectively analyzed the potential oncological benefit of PLND based on the 5% cut-off value on the Briganti nomogram. We obtained the data from the Medical Investigation Cancer Network (MICAN) Study, which included 3,463 patients who underwent a radical prostatectomy (RP) at nine institutions in Japan between 2010 and 2020. We included patients with Briganti scores ≥ 5% and a follow-up period ≥6 months and excluded patients categorized in the very high-risk group (based on NCCN categories); a final total of the cases of 1,068 patients were analyzed. The biochemical recurrence (BCR)-free survival was significantly worse in the patients who underwent PLND compared to those who did not (p=0.019). A multivariate analysis showed that high prostate-specific antigen (PSA) levels (p<0.001) and an advanced T-stage (p=0.018) were significant prognostic factors for BCR, whereas PLND had no effect on BCR (p=0.059). Thus, PLND in patients with prostate cancer whose Briganti score was 5% did not provide any oncological benefit. Further research is necessary to determine the indication criteria for conducting PLND. Competing Interests: No potential conflict of interest relevant to this article was reported.
Databáze:	MEDLINE
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