Login to Access Video or Poster Abstract: MP47-06
Sources of Funding: none

Introduction

To evaluate oncological outcomes of patients affected by pathologic node positive (LN+) prostate cancer (PCa) following radical prostatectomy and extended pelvic lymph node dissection (ePLND)._x000D_

Methods

We retrospectively evaluated 93 pts treated with open radical prostatectomy and ePLND between 2009 and 2014, with pathologic node positive disease (LN+). The ePLND consisted of the external iliac, obturator, internal iliac, presacral and common iliac nodal site up to the ureteric crossing. Specimens from each anatomic site were sent in separate packets. The estimated cancer-specific survival (CSS) and biochemical disease-free survival (bDFS) were calculate by Kaplan-Meier method. Multivariable Cox regression models assessed for prognostic factors of bDFS._x000D_

Results

Median follow-up was 48 months (range 14-89); six pts (6%) died of disease at follow-up, while 39 (42%) experienced biochemical failure (PSA > 0.2 ng/ml). Out of 93 patients, 53 pts did not receive adjuvant hormone therapy (AdjHT), 46 pts harboring ≤2 LN+. The median number of nodes removed was 22 (range 9-61). The mean and median number of positive nodes was 2.7 and 1 (range: 1-18), respectively. The estimated 5-year CSS was 90%; 5-year bDFS was 45%. Pts with ≤2 LN+ had significant better 5-year bDFS than those with > 2 LN+ (59% vs 15%; p<0.001). Pts with Gleason score 7 had better 5-year bDFS than those with Gleason score 8-10 (58% vs 36%; p=0.039). At multivariable Cox regression analysis, presence of more than 2 LN+ was an independent predictor of worse bDFS (p=0.026; HR 2.2). Among pts who did not receive AdjHT, the estimated 5-year bDFS was 60%, and was significantly higher in pts with ≤ 2 LN+ than those with > 2 LN+ (64% vs 34%; p=0.032).

Conclusions

Among pts with pathologic node positive disease following radical prostatectomy and ePLND, those with ≤ 2 LN+ showed more than 50% bDFS at 5-year follow-up. Good cancer control seems to be achieved also without AdjHT, in pts with limited nodal burden._x000D_ _x000D_

Funding

none