Login to Access Video or Poster Abstract: MP64-05
Sources of Funding: None

Introduction

Extended pelvic lymph node dissection (ePLND) is the optimal method of lymph node staging in prostate cancer. In the UK, radical prostatectomy has been performed in specialist centres since 2002. Since 2014 as part of a NHS transparency drive, a national registry collating outcomes after radical prostatectomy was set up and managed by the British Association of Urological Surgeons (BAUS). We report a detailed analysis of UK ePLND practice and lymph node invasion rates stratified by the 2016 WHO-approved new prostate cancer grading system.

Methods

All preoperative clinical N0 (cN0) patients undergoing radical prostatectomy with ePLND between January 1, 2014 and December 31, 2015 with surgeon/institution-reported data recorded in the BAUS registry were analysed.

Results

In total over the two year period 12857 radical prostatectomy cases were reported. Of these, 11462/12857 (89.1%) met the inclusion criteria and were cN0; 4591/11462 (40.1%) underwent pelvic lymph node dissection. In total 2224/4591 (48.4%) underwent ePLND, median age 65 years, median lymph node yield 13 nodes._x000D_ _x000D_ The surgical technique of ePLND was open 504 (22.6%), laparoscopic 467 (20.9%) or robotic 1253 (56.3%). Lymph node invasion rate stratified by pre-operative PSA 0-10ug/L,11-20ug/L and >20ug/L was 46/656(7.0%), 45/425(10.6%) and 24/153(15.7%) respectively. Lymph node invasion rate stratified by pre-operative clinical stage cT2 and cT3 was 92/829(11.1%) and 155/572(27.1%) respectively._x000D_ _x000D_ Table 1 Describes lymph node invasion rates stratified by the new grading system risk groups (p=ns) _x000D_

Conclusions

This UK-wide analysis demonstrates that ePLND is done increasingly commonly as the risk group grading increases in localised prostate cancer. However, lymph node invasion rates are not significantly different between the new grading classification risk groups, suggesting inaccuracy in staging for ePLND and/or limitations of current risk stratification methods.

Funding

None