Impact of minimal lymph node metastasis on long-term prognosis after radical prostatectomy
| Autor: | Michael J. Mihatsch, G Rutishauser, F Hering, H P Schmid |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Urology medicine.medical_treatment Adenocarcinoma Disease-Free Survival Metastasis Pelvis Prostate cancer medicine Humans Survival rate Lymph node Neoplasm Staging Prostatectomy business.industry Prostatic Neoplasms Radiotherapy Dosage Middle Aged medicine.disease Prognosis Surgery Survival Rate medicine.anatomical_structure Lymphatic Metastasis Lymph Node Excision Lymphadenectomy Radiotherapy Adjuvant Lymph business Radical retropubic prostatectomy Follow-Up Studies |
| Zdroj: | European urology. 31(1) |
| ISSN: | 0302-2838 |
| Popis: | Objectives: In the management of clinically localized prostate cancer, understaging is of major concern. There is a considerable therapeutic dilemma in those patients in whom staging lymphadenectomy prior to intended radical prostatectomy reveals lymph node metastases. Methods: Pelvic lymph node dissection and radical retropubic prostatectomy were performed in 132 consecutive patients. Patients with extracapsular disease and/or positive lymph nodes received adjuvant radiotherapy. Median follow-up after surgery was 7 years and 2 months. To study the influence of minimal lymph node metastasis, category pN 1 was further subdivided into pN 1,1 and pN 1.2 . Involvement of the prostatic capsule was either classified as infiltration (pT 3.1 ) or perforation (pT 3.2 ) of the capsule. Results: Disease-free survival after 10 years was 58% in patients with negative nodes, 37% in category pN 1.1 , 25% in category pN 1.2 and 10% in category pN 2 . Corrected overall survival was 83% for node-negative patients and 73% for category pN 1.1 , but it was only 33% for pN 1.2 and 29% for pN 2 . Patients in category pT 3.1 had a statistically significant better survival than those in pT Conclusions: We conclude that radical prostatectomy combined with adjuvant radiotherapy is a valuable option in prostate cancer patients with minimal lymph node metastasis. When compared to infiltration of the capsule, complete capsular perforation does adversely affect prognosis. |
| Databáze: | OpenAIRE |
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