scholarly journals Short-term outcomes of neoadjuvant chemohormonal therapy followed by radical prostatectomy for Chinese patients with regional lymph node metastatic prostate cancer

2020 ◽  
Vol 19 ◽  
pp. e1045
Author(s):  
J. Zhuang ◽  
X. Qiu ◽  
S. Zhang ◽  
H. Guo
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
Radical Prostatectomy ◽  
Metastatic Prostate Cancer ◽  
Regional Lymph Node ◽  
Chinese Patients ◽  
Short Term ◽  
Chemohormonal Therapy

Contemporary Trends and Survival Outcomes After Aborted Radical Prostatectomy in Lymph Node Metastatic Prostate Cancer Patients

2019 ◽  
Vol 5 (3) ◽  
pp. 381-388 ◽  
Author(s):  
Marco Bandini ◽  
Felix Preisser ◽  
Sebastiano Nazzani ◽  
Michele Marchioni ◽  
Zhe Tian ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
Radical Prostatectomy ◽  
Cancer Patients ◽  
Metastatic Prostate Cancer ◽  
Survival Outcomes

Clinical experience with extended lymph node dissection during radical prostatectomy

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 14545-14545
Author(s):  
G. Sonpavde ◽  
K. Slawin ◽  
J. M. Levitt ◽  
L. Guariguata
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
Radical Prostatectomy ◽  
Lymph Node Dissection ◽  
Regional Lymph Node ◽  
Adjuvant Radiation ◽  
Node Dissection ◽  
Extended Lymph Node Dissection ◽  
Open Radical Prostatectomy

14545 Background: The value of the extent of lymph node dissection at radical prostatectomy remains controversial. We report our experience with extended lymph node dissection in patients undergoing open radical prostatectomy. Methods: 201 consecutive patients with cT1c-cT3a prostate cancer who underwent open radical prostatectomy with an extended regional lymph node (LN) dissection of up to six packets (iliac, hypogastric, and obturator; right and left) by a single surgeon at The Methodist Hospital between July 2002 and April 2004 were studied. No patient was treated with adjuvant radiation or hormonal therapy before elevated PSA levels were observed. Ultrasensitive PSA (uPSA) using the 3rd generation Immulite assay (DPC) was performed periodically beginning at 6 weeks post operatively. A uPSA level ≥ 0.03 ng/mL and rising on at least one subsequent uPSA obtained at least six weeks later was classified as a biochemical recurrence (BCR). Results: The mean patient age was 59 years at the time of surgery (median, 59; range, 39 to 73 years). Median follow-up after surgery was 21 months (range 1–37 months). Gleason Score was ≤ 6, 7, and 8–10 in 37%, 53% and 10% of patients, respectively. Sixty-two patients had extra prostatic extension and 16 patients had seminal vesicle involvement. A total of 3125 pelvic lymph nodes were removed (per patient: mean, 15.64; median, 15; range 4–42). Of these 22 LN (0.71%) were positive in 11 (5.5%) patients. By specified region, 2/1775 (0.23%) of iliac nodes, 6/642 (0.93%) of hypogastric nodes and 9/708 (1.27%) of obturator nodes were positive. Of the 11 patients with positive LN, 3/11 (27.27%) had positive iliac nodes, 6/11 (54.54%) had positive hypogastric nodes, and 6/11 (54.54%) had positive obturator nodes. Using a very stringent definition of BCR in order to compensate for the relatively short follow-up period, the 2 year progression-free survival (PFS) for patients with at least one positive LN was 37.5%. Conclusions: Extended LN dissection may alter the biology of early nodal metastatic prostate cancer and lead to longterm PFS without additional therapy. A higher percentage of patients and nodes are positive in the hypogastric and obturator regions, supporting the rationale to include these with the iliac nodes when performing LN dissection. No significant financial relationships to disclose.

scholarly journals Re-assessment of 30-, 60- and 90-day mortality rates in non-metastatic prostate cancer patients treated either with radical prostatectomy or radiation therapy

2014 ◽  
Vol 8 (1-2) ◽  
pp. 75 ◽  
Author(s):  
Jens Hansen ◽  
Giorgio Gandaglia ◽  
Marco Bianchi ◽  
Maxine Sun ◽  
Michael Rink ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Radical Prostatectomy ◽  
Metastatic Prostate Cancer ◽  
Multivariable Analysis ◽  
Mortality Rates ◽  
External Beam Radiation ◽  
Short Term ◽  
Beam Radiation ◽  
Short Term Mortality

Introduction: It is customary to consider deaths that occur within 90 days of surgery as caused by that surgery. However, such practice may overestimate the true short-term mortality rates after radical prostatectomy (RP). Indeed, treatment-unrelated events might affect short-term mortality rates. We assess RP-specific excess short-term mortality.Methods: We performed a retrospective analysis of a population-based cohort of 59 010 patients (RP = 28 281 and external beam radiation therapy [EBRT] as reference group, n = 30 729) who were treated between 1998 and 2005 for non-metastatic prostate cancer. Using univariate and multivariate logistic regression analyses, we assessed the rates of 30-, 60- and 90-day mortality after either RP or EBRT.Results: Within the cohort, 30-, 60- and 90-day mortality rates were 0.2, 0.5 and 0.6%, and 0.1, 0.4 and 0.6% for RP and EBRT patients, respectively. This resulted in overall 30-, 60, and 90- day mortality differences of 0.1, 0.1 and 0%, respectively. After stratification according to age and Charlson comorbidity index (CCI), the magnitude of these differences increased up to 3.2% in favour of EBRT in patients aged >75 years with CCI ≥2. In multivariable analysis, rates of 30-, 60- and 90-day mortality were 5.2-, 1.8- and 1.3-fold higher after RP than EBRT, respectively. Our study is limited by its non-randomized design.Conclusion: Overall, absolute short-term mortality rates after RP are comparable to those of EBRT. The difference decreases over time: 90 days <60 days <30 days. Nonetheless, their magnitude is far from trivial in the elderly and sickest patients.

scholarly journals Prognostic Impact of Pelvic Lymph Node Dissection During Radical Prostatectomy on Patients With High-risk Prostate Cancer Treated With Neoadjuvant Chemohormonal Therapy

2021 ◽  
Author(s):  
Hiromichi Iwamura ◽  
Shingo Hatakeyama ◽  
Takuma Narita ◽  
Yusuke Ozaki ◽  
Sakae Konishi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
High Risk ◽  
Radical Prostatectomy ◽  
Lymph Node Dissection ◽  
Pelvic Lymph Node Dissection ◽  
Node Dissection ◽  
Chemohormonal Therapy ◽  
High Risk Prostate Cancer ◽  
Risk Prostate Cancer

Abstract BackgroundWe aimed to determine the prognostic and staging benefit of limited pelvic lymph node dissection (PLND) during radical prostatectomy (RP) in high-risk prostate cancer (PC) patients treated with neoadjuvant chemohormonal therapy.MethodsWe retrospectively analyzed 516 patients with high-risk localized PC (<cT4N0M0) who received neoadjuvant androgen-deprivation therapy plus estramustine phosphate followed by RP between January 2010 and March 2020. Since we stopped limited-PLND for such patients in October 2015, we compared the biochemical recurrence-free survival (BCR-FS) between the limited-PLND group (before October 2015, n = 283) and the non-PLND group (after November 2015, n = 233).ResultsThe rate of node metastases in the limited-PLND group were 0.8% (2/283). Operation time was significantly longer (176 vs. 162 min) and the rate of surgical complications were much higher (all grades; 19 vs. 6%, grade ≥ 3; 3 vs. 0%) in the limited-PLND group. The inverse probability of treatment weighting-Cox analysis revealed limited PLND had no significant impact on BCR-FS (hazard ratio, 1.31; P = 0.421).ConclusionsLimited PLND during RP after neoadjuvant chemohormonal therapy showed a relatively low rate of positive nodes, higher rate of complications, and no significant impact on BCR-FS.

scholarly journals Integrating chemohormonal therapy and surgery in known or suspected lymph node metastatic prostate cancer

2015 ◽  
Vol 18 (3) ◽  
pp. 276-280 ◽  
Author(s):  
A J Zurita ◽  
L L Pisters ◽  
X Wang ◽  
P Troncoso ◽  
P Dieringer ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
Metastatic Prostate Cancer ◽  
Chemohormonal Therapy
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