Cancer-Specific Mortality Differences in Specimen-Confined Radical Prostatectomy Patients According to Lymph Node Invasion

被引：1

作者：

Barletta, Francesco ^{[1
,2
,3
]}

Tappero, Stefano ^{[1
,3
,4
,5
]}

Morra, Simone ^{[1
,3
,6
]}

Incesu, Reha-Baris ^{[1
,3
,7
]}

Garcia, Cristina Cano ^{[1
,3
,8
]}

Piccinelli, Mattia Luca ^{[1
,3
,9
]}

Scheipner, Lukas ^{[1
,3
,10
]}

Baudo, Andrea ^{[1
,3
,11
,12
]}

Tian, Zhe ^{[1
,3
]}

Gandaglia, Giorgio ^{[2
]}

Stabile, Armando ^{[2
]}

Mazzone, Elio ^{[2
]}

Terrone, Carlo ^{[4
,5
]}

Longo, Nicola ^{[6
]}

Tilki, Derya ^{[2
,7
,13
,14
]}

Chun, Felix K. H. ^{[8
]}

de Cobelli, Ottavio ^{[9
]}

Ahyai, Sascha ^{[10
]}

Carmignani, Luca ^{[11
,12
]}

Saad, Fred ^{[3
]}

Shariat, Shahrokh F. ^{[15
,16
,17
,18
]}

Montorsi, Francesco ^{[2
]}

Briganti, Alberto ^{[2
]}

Karakiewicz, Pierre I. ^{[1
,3
]}

机构：

[1] Univ Montreal, Hlth Ctr, Div Urol, Canc Prognost & Hlth Outcomes Unit, Montreal, PQ, Canada

[2] IRCCS San Raffaele Sci Inst, Div Oncol, Gianfranco Soldera Prostate Canc Lab, Unit Urol, I-20132 Milan, Italy

[3] Univ Vita Salute San Raffaele, Milan, Italy

[4] IRCCS Policlin San Martino, Dept Urol, Genoa, Italy

[5] Univ Genoa, Dept Surg & Diagnost Integrated Sci DISC, Genoa, Italy

[6] Univ Naples Federico II, Dept Neurosci Sci Reprod & Odontostomatol, Naples, Italy

[7] Univ Hosp Hamburg Eppendorf, Martini Klin Prostate Canc Ctr, Hamburg, Germany

[8] Goethe Univ Frankfurt Main, Univ Hosp Frankfurt, Dept Urol, Frankfurt, Germany

[9] IRCCS, IEO European Inst Oncol, Dept Urol, Milan, Italy

[10] Med Univ Graz, Dept Urol, Graz, Austria

[11] IRCCS Osped Galeazzi St Ambrogio, Dept Urol, Milan, Italy

[12] IRCCS Policlin San Donato, Dept Urol, Milan, Italy

[13] Univ Hosp Hamburg Eppendorf, Dept Urol, Hamburg, Germany

[14] Koc Univ Hosp, Dept Urol, Istanbul, Turkiye

[15] Med Univ Vienna, Comprehens Canc Ctr, Dept Urol, Vienna, Austria

[16] Weill Cornell Med Coll, Dept Urol, New York, NY USA

[17] Univ Texas Southwestern, Dept Urol, Dallas, TX USA

[18] AL Ahliyya Amman Univ, Hourani Ctr Appl Sci Res, Amman, Jordan

来源：

CLINICAL GENITOURINARY CANCER | 2023年 / 21卷 / 06期

关键词：

SEER program; Prostate cancer; Organ confined; GALLIUM NITRIDE; EXTRAPROSTATIC EXTENSION; REMOVAL MECHANISM; SUBSURFACE DAMAGE; GAN; SURVIVAL; SIMULATION; PARAMETERS; GROWTH; RF;

D O I：

10.1016/j.clgc.2023.05.010

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

It is not clear whether cancer specific mortality (CSM) differences exist in radical prostatectomy (RP) treated prostate cancer (PCa) patients with specimen-confined (pT2) stage according to presence of lymph node invasion (LNI). Overall, 32,258 patients with pT2 PCa at RP + LND were identified. Of these, 448 (1.4%) patients harbored LNI. In multivariable Cox-regression models pN1 independently predicted higher CSM (HR: 4.4, P < .001). In sensitivity analyses addressing pT2 pN1 patients, 5-year CSM-free estimates were 99.3, 100 and 84.4% for ISUP GG 1-3 vs. 4 vs. 5, respectively ( P < .001). These findings might be of value for clinical decision making, as well as for individual patient counseling.Purpose: To test cancer-specific mortality (CSM) differences in specimen-confined (pT2) prostate cancer (PCa) at radical prostatectomy (RP) with lymph node dissection (LND) according to lymph node invasion (LNI). Methods: RP + LND pT2 PCa patients were identified (surveillance, epidemiology, and end results 2010-2015). CSM-FS rates were tested in Kaplan-Meier plots and multivariable Cox-regression (MCR) models. Sensitivity analyses respectively addressing patients with 6 or more lymph nodes analyzed and pT2 pN1 patients were performed. Results: Overall, 32,258 patients with pT2 PCa at RP + LND were identified. Of these, 448 (1.4%) patients harbored LNI. Five-year CSM-free estimates were 99.6% for pN0 vs. 96.4% for pN1 (P < .001). In MCR models, pN1 (HR: 3.4, P < .001) independently predicted higher CSM. In sensitivity analyses addressing patients with 6 or more lymph nodes analyzed (n = 15,437), 328 (2.1%) pN1 patients were identified. In this subgroup, 5-year CSM-free estimates were 99.6% for pN0 vs. 96.3% for pN1 (P < .001) and, in MCR models, pN1 independently predicted higher CSM (HR: 4.4, P < .001). In sensitivity analyses addressing pT2 pN1 patients, 5-year CSM-free estimates were 99.3, 100 and 84.8% for ISUP GG 1-3 vs. 4 vs. 5, respectively (P < .001). Conclusions: In patients with pT2 PCa a small proportion harbor LNI (1.4%-2.1%). In such patients, CSM rate is higher (HR 3.4-4.4, P < .001). This higher CSM risk seems to virtually exclusively apply to ISUP GG5 patients (84.8% 5-year CSM-free rate).

引用

页码：E461 / +

页数：7

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