Features and management of men with pN1 cM0 prostate cancer after radical prostatectomy and lymphadenectomy: a systematic review of population-based evidence
| Autor: | Christian D. Fankhauser, Claudia Kesch, Igor Tsaur, Veeru Kasivisvanathan, Jonathan Olivier, Felix Preisser, Fabio Zattoni, Guillaume Ploussard, Marco Moschini, Ignacio Puche-Sanz, Isabel Heidegger, Peter Ka-Fung Chiu, Derya Tilki, Alexander Kretschmer, M. Valerio, G. Marra, Francesco Ceci, Charles Laine, Constance Thibault, Roderick C.N. van den Bergh, Benjamin Pradere, Giorgio Gandaglia |
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| Rok vydání: | 2022 |
| Předmět: |
Male
Oncology medicine.medical_specialty Urology medicine.medical_treatment Medizin population-based studies positive nodes Androgen deprivation therapy Prostate cancer Quality of life Internal medicine Humans Medicine Stage (cooking) Lymph node Adjuvant Neoplasm Staging Retrospective Studies Prostatectomy Radiotherapy business.industry Prostatic Neoplasms Androgen Antagonists lymph node Prostate-Specific Antigen prostate cancer medicine.disease radical prostatectomy Prostate-specific antigen medicine.anatomical_structure Lymph Node Excision Lymphatic Metastasis Quality of Life Radiotherapy Adjuvant Lymphadenectomy Population-based studies Positive nodes Radical prostatectomy business |
| Zdroj: | Current Opinion in Urology. 32:69-84 |
| ISSN: | 1473-6586 0963-0643 |
| Popis: | Purpose of review To investigate the features and optimal management of pN+ cM0 prostate cancer (PCa) according to registry-based studies. Recent findings Up to 15% of PCa patients harbor lymph node invasion (pN+) at radical prostatectomy plus lymph node dissection. Nonetheless, the optimal management strategy in this setting is not well characterized. Summary We performed a systematic review including n = 13 studies. Management strategies comprised 13 536 men undergoing observation, 11 149 adjuvant androgen deprivation therapy (aADT), 7,075 adjuvant radiotherapy (aRT) +aADT and 705 aRT. Baseline features showed aggressive PCa in the majority of men. At a median follow-up ranging 48-134months, Cancer-related death was 5% and overall-mortality 16.6%. aADT and aRT alone had no cancer-specific survival or overall survival advantages over observation only and over not performing aRT, respectively. aADT plus aRT yielded a survival benefit compared to observation and aADT, which in one study, were limited to certain intermediate-risk categories. Age, Gleason, Charlson score, positive surgical margins, pathological stage, and positive nodes number, but not prostate specific antigen, were most relevant prognostic factors. Our work further confirmed pN+ PCa is a multifaceted disease and will help future research in defining its optimal management based on different risk categories to maximize survival and patient's quality of life. |
| Databáze: | OpenAIRE |
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