Association between Lymph Node Counts and Oncological Outcomes in Lymph Node Positive Prostate Cancer

Area of Science:

• Urology
• Oncology
• Surgical Pathology

Background:

• Pelvic lymph node dissection (PLND) during radical prostatectomy (RP) is crucial for diagnosis.
• Its therapeutic impact on cancer outcomes remains under investigation.

Purpose of the Study:

• To determine the association between lymph node (LN) counts and oncological outcomes in pN1 patients post-RP.
• To clarify the prognostic significance of total harvested LNs versus positive LNs.

Main Methods:

• Retrospective analysis of 706 LN-positive patients undergoing RP and PLND (1998-2012).
• Evaluation of harvested and positive LN counts using univariate and multivariate Cox regression.
• Follow-up median of 47.8 months.

Main Results:

• The total number of removed LNs did not significantly predict oncological outcomes (recurrence, metastasis, cancer-specific survival).
• A higher number of positive LNs was significantly associated with increased risk of metastasis and cancer-specific mortality.
• Mean removed LNs: 15.0; Mean positive LNs: 2.4.

Conclusions:

• The number of positive lymph nodes is a significant predictor of adverse oncological outcomes in pN1 patients.
• The total number of harvested lymph nodes is not a significant prognostic factor in this cohort.
• Findings emphasize the prognostic importance of positive nodal status over nodal yield.