Characterization of Lymph Node Tumor Burden in Node-Positive Prostate Cancer Patients after Robotic-Assisted Radical...

Area of Science:

• Oncology
• Urology
• Pathology

Background:

• Current prostate cancer (PCa) nodal staging lacks metrics for lymph node (LN) tumor burden.
• The impact of LN tumor burden, anatomical compartment, and extranodal extension (ENE) on biochemical recurrence-free survival (BRFS) remains understudied.

Purpose of the Study:

• To investigate the association between quantitative lymph node tumor burden metrics and BRFS in prostate cancer patients.
• To evaluate the relationship between LN anatomical compartments, ENE extent, and BRFS.

Main Methods:

• Histopathological review of 66 pN1 prostate cancer patients after extended pelvic lymph node dissection.
• Quantification of LN tumor burden using metrics such as deposit size, total span, and percentage of LN surface area involved.
• Characterization of LN anatomical compartments and quantification of ENE extent.

Main Results:

• Lymph node tumor burden metrics, including mean largest LN deposit size (aHR=1.91), mean total span of deposits (aHR=2.07), and mean percent LN surface area involved (aHR=1.58), were significantly associated with BRFS (p<0.001).
• Neither the LN anatomical compartment nor the quantified extent of ENE demonstrated a significant association with BRFS.

Conclusions:

• Lymph node tumor burden is a significant predictor of biochemical recurrence-free survival in prostate cancer.
• The anatomical compartment of lymph node involvement and extranodal extension are not significant predictors of BRFS in this cohort.