Incidence of positive pelvic lymph nodes in patients with prostate cancer, a prostate‐specific antigen (PSA) level of ≤10 ng/mL and biopsy Gleason score of ≤6, and their influence on PSA progression‐free survival after radical prostatectomy

• Published in: BJU international 2006-06, Vol.97 (6), p.1173-1178
• Main Authors: WECKERMANN, DOROTHEA, GOPPELT, MARCUS, DORN, ROBERT, WAWROSCHEK, FRIEDHELM, HARZMANN, ROLF
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Disease Progression; Disease-Free Survival; Humans; Lymph Node Excision - methods; Lymph Nodes - pathology; lymphatic metastases; Lymphatic Metastasis - pathology; Male; Medical sciences; Middle Aged; Neoplasm Recurrence, Local - mortality; Neoplasm Recurrence, Local - pathology; Neoplasm Staging - methods; Nephrology. Urinary tract diseases; Pelvis - pathology; Prostate-Specific Antigen - blood; prostatectomy; Prostatectomy - methods; Prostatectomy - mortality; prostatic neoplasm; Prostatic Neoplasms - blood; Prostatic Neoplasms - mortality; Prostatic Neoplasms - pathology; Prostatic Neoplasms - surgery; Risk Factors; Sentinel Lymph Node Biopsy - methods; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the genital tract and mammary gland; Tumors of the urinary system; Urinary tract. Prostate gland
• ISSN: 1464-4096; 1464-410X
• DOI: 10.1111/j.1464-410X.2006.06166.x

OBJECTIVE To investigate how many men with low‐risk prostate cancer had positive lymph nodes detected by radio‐guided surgery and whether they had a higher biochemical relapse rate after radical prostatectomy, because in such patients most urologists dispense with operative lymph node staging, as nomograms indicate only a low percentage of lymph node metastases. PATIENTS AND METHODS The study included 474 men with a prostate‐specific antigen (PSA) level of ≤ 10 ng/mL, biopsy Gleason score of ≤ 6 and positive biopsies in one (group 1, 315 men) or both lobes (group 2, 159 men); follow‐up data were available in 357 men. Men with adjuvant radiation or hormone therapy before the occurrence of biochemical relapse were excluded. RESULTS Positive lymph nodes were detected in 17 men in group 1, and in 18 in group 2. In more than half of the patients (19/35) these nodes were found outside the region of standard lymphadenectomy. Men with node‐positive disease had a higher biochemical relapse rate (P