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Single Positive Lymph Node Prostate Cancer Can Be Treated Surgically without Recurrence.

Dae Keun Kim1,2, Kyo Chul Koo3, Ali Abdel Raheem3,4

  • 1Department of Urology, CHA Seoul Station Medical Center, CHA University, CHA Medical School, Seoul, Republic of Korea.

Plos One
|April 1, 2016
PubMed
Summary

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Prostate cancer (PCa) patients with pN1 stage and a Gleason score of 7 or less have a low risk of recurrence after surgery. These patients may benefit from close observation and delayed adjuvant hormone therapy.

Area of Science:

  • Urology
  • Oncology
  • Surgical Oncology

Background:

  • Prostate cancer (PCa) staging is crucial for treatment planning.
  • pN1 stage indicates cancer spread to regional lymph nodes.
  • Adjuvant treatment strategies for pN1 PCa vary.

Purpose of the Study:

  • To evaluate the outcomes of pN1 PCa patients treated with radical prostatectomy without immediate adjuvant therapy.
  • To identify predictors of recurrence and survival in this cohort.

Main Methods:

  • Retrospective analysis of 87 pN1 PCa patients undergoing robot-assisted radical prostatectomy (RARP) or radical prostatectomy (RP).
  • Kaplan-Meier analysis for biochemical recurrence (BCR)-free survival, metastasis-free survival (MFS), cancer-specific survival (CSS), and overall survival (OS).

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  • Cox regression analysis to assess the impact of clinical and pathological factors on survival outcomes.

    • Main Results:

    • The 5-year OS and CSS rates were 86.1% and 89.6%, respectively.
    • Presence of 2 or more positive lymph nodes (LNs) and Gleason score ≥8 were significant negative predictors of BCR-free survival.
    • 2 or more positive LNs predicted shorter metastasis-free survival.
    • Patients with a single positive LN and Gleason score ≤7 demonstrated a significantly low risk of disease progression.

    Conclusions:

    • pN1 PCa patients exhibit diverse clinical trajectories.
    • A subset of pN1 patients with single positive LN and Gleason score ≤7 have a low risk of recurrence.
    • Observation with delayed adjuvant hormone therapy may be a viable option for select pN1 PCa patients.