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Related Experiment Videos

Extranodal extension in lymph node-positive prostate cancer.

L Cheng1, T M Pisansky, D M Ramnani

  • 1Department of Pathology, Indiana University School of Medicine, Indianapolis 46202, USA. lcheng@iupui.edu

Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc
|March 4, 2000
PubMed
Summary

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Extranodal extension (ENE) does not significantly impact survival in node-positive prostate cancer patients. Nodal cancer volume, however, is a key predictor of distant metastasis and cancer-specific survival in these patients.

Area of Science:

  • Urology
  • Oncology
  • Pathology

Background:

  • Extranodal tumor extension (ENE) is a potential prognostic factor in epithelial malignancies.
  • Its prognostic value in prostate cancer with lymph node metastasis requires further clarification.

Purpose of the Study:

  • To evaluate the prognostic significance of extranodal extension (ENE) in node-positive prostate cancer patients.
  • To determine if ENE impacts distant metastasis-free and cancer-specific survival.

Main Methods:

  • Retrospective analysis of 212 node-positive prostate cancer patients treated with radical prostatectomy, pelvic lymphadenectomy, and androgen deprivation (1987-1992).
  • ENE defined as cancer perforating lymph node capsule; nodal cancer volume measured by grid method.
  • Univariate and multivariate Cox proportional models used to estimate risk ratios for survival outcomes.

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Main Results:

  • Extranodal extension (ENE) was present in 59% of patients and was not significantly associated with distant metastasis-free or cancer-specific survival.
  • In patients with a single positive node, ENE did not significantly affect survival outcomes.
  • Nodal cancer volume, but not ENE, was significantly associated with adverse distant metastasis-free and cancer-specific survival after adjusting for Gleason score and DNA ploidy.

Conclusions:

  • Extranodal extension (ENE) is not associated with unfavorable survival in node-positive prostate cancer patients undergoing radical prostatectomy, pelvic lymphadenectomy, and androgen deprivation therapy.
  • Nodal cancer volume is a significant predictor of survival outcomes in this patient cohort.