Risk Model for Lymph Node-Positive Prostate Cancer After Radical Prostatectomy

Area of Science:

• Urology
• Oncology
• Medical Statistics

Background:

• Post-radical prostatectomy (RP) lymph node positivity (pN1) is a significant predictor of prostate cancer progression.
• Optimal treatment strategies for pN1 patients remain unclear, necessitating better prognostic tools.

Purpose of the Study:

• To develop a risk model for predicting survival outcomes in patients with pN1 prostate cancer.
• To identify independent prognostic factors for metastasis-free survival (MFS) in this patient cohort.

Main Methods:

• Retrospective analysis of 528 pN1 patients undergoing RP and pelvic lymph node dissection (2006-2019).
• Utilized a least absolute shrinkage and selection operator (LASSO)-penalized, multivariate Cox regression model to establish a risk model and nomogram for MFS prediction.

Main Results:

• Identified Grade Group (GGs 4-5), pathological T-stage (pT3b or more), number of positive lymph nodes, and positive lymph node diameter (>2 mm) as independent prognostic factors for 60-month MFS.
• The study established a risk model and nomogram incorporating these factors.

Conclusions:

• A novel risk model and nomogram were developed to predict MFS in pN1 prostate cancer patients.
• Further randomized controlled trials are essential to determine optimal postoperative treatment strategies for pN1 patients.