AIM: To determine clinical factors associated with multiple bilateral lymph node micrometastases and seminal vesicle invasion (pT3b) in organ-confined prostate cancer (PCa). METHODS: The study excluded patients under androgen deprivation, with lymph node involvement (cN1 status), and having undergone unilateral pelvic lymph node dissection (PLND) during radical prostatectomy (RP). Lymph node micrometastases were classified as unilateral (pN1m) and bilateral (pN1b). Analysis considered multivariate multinomial logistic regression models. RESULTS: Between January 2013 and March 2015, 140 patients underwent PLND during RP. Lymph node micrometastases were detected in 28 cases (20%) including pN1m in 19 (13.6%) and pN1b in 9 (6.4%). Independent clinical predictors of pN1b included prostate-specific antigen (PSA, µg/L) >12.5 (odds ratio [OR] = 43.0), proportion of positive biopsy cores (PBC) >0.57 (OR = 6.7), and biopsy Gleason grade (bGG) >3 (OR = 7.5). Independent pT3b predictors included PSA>12.5 (OR = 3.8), PBC>0.57 (OR = 4.1), and bGG>3 (OR = 3.8). CONCLUSIONS: In cN0 patients with localized PCa undergoing PLND, a nonnegligible rate of multiple lymph node micrometastases was detected (32.2%). In the natural history of PCa, there is a close association between pT3b and pN1b disease. Prostate cancer patients who are at high risk of extraglandular extension need selective pelvic staging by multiparametric magnetic resonance imaging to assess seminal vesicle invasion. Operated patients with pT3b and pNx status need close PSA monitoring because of the high probability of occult multiple bilateral lymph node micrometastases.
AIM: To determine clinical factors associated with multiple bilateral lymph node micrometastases and seminal vesicle invasion (pT3b) in organ-confined prostate cancer (PCa). METHODS: The study excluded patients under androgen deprivation, with lymph node involvement (cN1 status), and having undergone unilateral pelvic lymph node dissection (PLND) during radical prostatectomy (RP). Lymph node micrometastases were classified as unilateral (pN1m) and bilateral (pN1b). Analysis considered multivariate multinomial logistic regression models. RESULTS: Between January 2013 and March 2015, 140 patients underwent PLND during RP. Lymph node micrometastases were detected in 28 cases (20%) including pN1m in 19 (13.6%) and pN1b in 9 (6.4%). Independent clinical predictors of pN1b included prostate-specific antigen (PSA, µg/L) >12.5 (odds ratio [OR] = 43.0), proportion of positive biopsy cores (PBC) >0.57 (OR = 6.7), and biopsy Gleason grade (bGG) >3 (OR = 7.5). Independent pT3b predictors included PSA>12.5 (OR = 3.8), PBC>0.57 (OR = 4.1), and bGG>3 (OR = 3.8). CONCLUSIONS: In cN0 patients with localized PCa undergoing PLND, a nonnegligible rate of multiple lymph node micrometastases was detected (32.2%). In the natural history of PCa, there is a close association between pT3b and pN1b disease. Prostate cancerpatients who are at high risk of extraglandular extension need selective pelvic staging by multiparametric magnetic resonance imaging to assess seminal vesicle invasion. Operated patients with pT3b and pNx status need close PSA monitoring because of the high probability of occult multiple bilateral lymph node micrometastases.
Authors: Antonio Benito Porcaro; Marco Sebben; Paolo Corsi; Alessandro Tafuri; Tania Processali; Marco Pirozzi; Nelia Amigoni; Riccardo Rizzetto; Giovanni Cacciamani; Arianna Mariotto; Alberto Diminutto; Matteo Brunelli; Vincenzo De Marco; Salvatore Siracusano; Walter Artibani Journal: J Robot Surg Date: 2019-04-05
Authors: Antonio B Porcaro; Alessandro Tafuri; Marco Sebben; Paolo Corsi; Tania Processali; Marco Pirozzi; Davide De Marchi; Davide Inverardi; Maria A Cerruto; Nelia Amigoni; Riccardo Rizzetto; Matteo Brunelli; Roberto Iacovelli; Salvatore Siracusano; Walter Artibani Journal: Curr Urol Date: 2019-07-20
Authors: Antonio B Porcaro; Alessandro Tafuri; Marco Sebben; Paolo Corsi; Tania Processali; Marco Pirozzi; Nelia Amigoni; Riccardo Rizzetto; Aliasger Shakir; Giovanni Cacciamani; Arianna Mariotto; Matteo Brunelli; Riccardo Bernasconi; Giovanni Novella; Vincenzo De Marco; Walter Artibani Journal: Arab J Urol Date: 2019-05-30