Is Pelvic Lymph Node Dissection Necessary in Patients with a Serum PSA<10ng/ml Undergoing Radical Prostatectomy for Prostate Cancer?

Schumacher, Martin C; Burkhard, Fiona C; Thalmann, George N; Fleischmann, Achim; Studer, Urs E (2006). Is Pelvic Lymph Node Dissection Necessary in Patients with a Serum PSA<10ng/ml Undergoing Radical Prostatectomy for Prostate Cancer? European urology, 50(2), pp. 272-9. Amsterdam: Elsevier 10.1016/j.eururo.2006.01.061

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OBJECTIVE: Controversy persists concerning the role of pelvic lymph node dissection (PLND) in patients with preoperative PSA values <10ng/ml undergoing treatment for prostate cancer with a curative intent. The aim of this study was to determine the incidence of lymph node metastasis in this subgroup of patients. METHODS: Patients with clinically localized prostate cancer and a serum PSA<10ng/ml, without neoadjuvant hormonal or radiotherapy, with negative staging examinations who underwent radical retropubic prostatectomy with bilateral extended PLND and with >/=10 lymph nodes detected by the pathologist in the surgical specimen, were included in the study. RESULTS: A total of 231 patients with a median serum PSA of 6.7ng/ml (range 0.4-9.98) and a median age of 62 years (range 44-76) were evaluated. A median of 20 (range 10-72) nodes were removed per patient. Positive nodes were found in 26 of 231 patients (11%), the majority of which (81%) had a Gleason score >/=7 in the surgical specimen. Of the patients with a Gleason score >/=7 in the prostatectomy specimen 25% had positive nodes, whereas only 3% with a Gleason score </=6 were node positive. CONCLUSIONS: The incidence of positive nodes in patients with clinically localized prostate cancer, a serum PSA<10ng/ml and a Gleason score >/=7 in the prostatectomy specimen was 25% after extended PLND. It seems that in this patient group extended PLND, including removal of nodes along the internal iliac vessels, is warranted.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Urology
04 Faculty of Medicine > Service Sector > Institute of Pathology

UniBE Contributor:

Burkhard, Fiona C.; Thalmann, George; Fleischmann, Achim and Studer, Urs

ISSN:

0302-2838

ISBN:

16632187

Publisher:

Elsevier

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:46

Last Modified:

06 Dec 2013 13:42

Publisher DOI:

10.1016/j.eururo.2006.01.061

PubMed ID:

16632187

Web of Science ID:

000239468800020

URI:

https://boris.unibe.ch/id/eprint/19259 (FactScience: 1754)

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