Does radical prostatectomy in the presence of positive pelvic lymph nodes enhance survival?

A retrospective review was performed on all patients with stage D1 prostate cancer treated at Duke University Medical Center between 1975 and 1989. A total of 156 patients underwent staging pelvic lymph-node dissection for clinically organ-confined prostate cancer (stage A or B) but were found to ha...

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Bibliographic Details
Published in:World journal of urology 1994-12, Vol.12 (6), p.308-312
Main Authors: FRAZIER, H. A, ROBERTSON, J. E, PAULSON, D. F
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Combined Modality Therapy
Humans
Lymph Node Excision
Lymphatic Metastasis
Male
Medical sciences
Middle Aged
Nephrology. Urinary tract diseases
Proportional Hazards Models
Prostatectomy
Prostatic Neoplasms - mortality
Prostatic Neoplasms - pathology
Prostatic Neoplasms - surgery
Retrospective Studies
Survival Analysis
Survival Rate
Tumors of the urinary system
Urinary tract. Prostate gland
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Summary:A retrospective review was performed on all patients with stage D1 prostate cancer treated at Duke University Medical Center between 1975 and 1989. A total of 156 patients underwent staging pelvic lymph-node dissection for clinically organ-confined prostate cancer (stage A or B) but were found to have disease metastatic to the pelvic lymph nodes (stage D1). Of this population, 42 patients also underwent radical prostatectomy (group 1), leaving 114 who did not have their prostate removed (group 2). The median cancer-specific survival was 11.2 years for group 1 versus 5.8 years for group 2 (P = 0.005). In patients with one or two positive lymph nodes the median cancer-specific survival was 10.2 years for group 1 versus 5.9 years for group 2 (P = 0.015). There was no difference in survival if three or more lymph nodes were positive. Adjuvant treatment with immediate androgen deprivation and/or postoperative radiation therapy failed to improve the survival experience. The incidence of local problems, including stricture formation, bleeding, or regrowth of cancer requiring dilation or surgical intervention (transurethral prostatectomy) averaged 9.5% in group 1 and 24.6% in group 2. These data show that patients with limited node-positive disease selected for radical prostatectomy experience a survival advantage over those denied such therapy and that this advantage is independent of adjunctive therapy.
ISSN:0724-4983
1433-8726
DOI:10.1007/BF00184109