Pathologically Node-Positive Prostate Carcinoma - Prevalence, Pattern of Care and Outcome From a Population-Based...

Area of Science:

• Urology
• Oncology
• Cancer Research

Background:

• Prostate cancer (P-Ca) management requires understanding outcomes for pathologically node-positive (pN+) disease post-radical prostatectomy.
• Evaluating trends in pN+ P-Ca care and outcomes is essential for improving patient management.

Purpose of the Study:

• To assess the prevalence, care patterns, and outcomes of pN+ P-Ca patients following radical prostatectomy.
• To identify prognostic factors influencing survival and metastasis-free survival in pN+ P-Ca.

Main Methods:

• Retrospective analysis of 4723 patients undergoing radical prostatectomy from a provincial cancer registry (2005-2014).
• Identification of 167 pN+ P-Ca patients, with analysis of postoperative prostate-specific antigen (PSA) levels and treatment modalities.
• Survival estimation using Kaplan-Meier method and analysis of prognostic factors via univariate and multivariate analyses.

Main Results:

• Overall survival at 5 and 10 years was 89% and 81%, respectively; distant metastasis-free survival (DMFS) was 77% and 58%.
• Persistently elevated postoperative PSA (≥0.2 ng/mL) was significantly associated with poorer DMFS (HR 4.4, P=0.002).
• Sensitivity analyses confirmed the association of elevated postoperative PSA (≥0.1 ng/mL and ≥0.4 ng/mL) with DMFS.

Conclusions:

• A significant association exists between persistently elevated postoperative PSA and reduced DMFS in pN+ P-Ca patients.
• Postoperative PSA levels are a critical factor in tailoring treatment strategies for pN+ P-Ca.
• The study highlights the importance of monitoring PSA for predicting outcomes in node-positive prostate cancer.