Hakan Turk1, Sıtkı Ün2, Osman Koca3, Ahmet Cinkaya4, Hilmi Kodaz5, Ferruh Zorlu6. 1. Department of Urology, Faculty of Medicine, Evliya Celebi Training and Research Hospital, Dumlupinar University, Kütahya 43100, Turkey. 2. Department of Urology, Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey. 3. Department of Urology, Can Hospital, Manisa, Turkey. 4. Department of Radiation Oncology, Faculty of Medicine, Evliya Celebi Training and Research Hospital, Dumlupinar University, Kütahya 43100, Turkey. 5. Department of Medical Oncology, Faculty of Medicine, Evliya Celebi Training and Research Hospital, Dumlupinar University, Kütahya 43100, Turkey. 6. Department of Urology, Tepecik Training and Research Hospital, İzmir, Turkey.
Abstract
OBJECTIVE: We aimed to demonstrate the effects of clinical evaluations as well as biopsy characteristics in terms of lymph node involvement (LNI) despite the small number of patients in our study. MATERIALS AND METHODS: A total of 221 patients who underwent radical prostatectomy (RP) and extended pelvic lymph node dissection (ePLND) in our clinic between 2010 and 2015 and who met the inclusion criteria were enrolled in our study group. All of the patients were evaluated in terms of age, prostate-specific antigen (PSA) value before transrectal ultrasound-guided prostate biopsy (TRUSPB), digital rectal examination, Gleason score (GS) on TRUSPB, percentage of positive cores on TRUSPB, total number of positive cores, highest percentage of cancer in positive cores, and number of lymph nodes removed at RP. Pathological examination of the data of RP specimens, PSA values in follow-up after surgery, and follow-up periods was recorded. The TNM 2009 classification was used for staging. RESULTS: In the evaluation of LNI risk, as regards the assessment of predictors and outcomes with respect to the univariate and multivariate analyses, LNI was found in the univariate analysis to be associated with GS, clinical stage, number of lymph nodes removed according to the D'Amico risk classification. In the multivariate analysis, however, the number of lymph nodes removed was found significant. CONCLUSION: Risk stratification should be considered in patients with prostate cancer while selecting the patients who would undergo pelvic lymphadenectomy. In addition, ePLND should be performed to patients undergoing lymphadenectomy.
OBJECTIVE: We aimed to demonstrate the effects of clinical evaluations as well as biopsy characteristics in terms of lymph node involvement (LNI) despite the small number of patients in our study. MATERIALS AND METHODS: A total of 221 patients who underwent radical prostatectomy (RP) and extended pelvic lymph node dissection (ePLND) in our clinic between 2010 and 2015 and who met the inclusion criteria were enrolled in our study group. All of the patients were evaluated in terms of age, prostate-specific antigen (PSA) value before transrectal ultrasound-guided prostate biopsy (TRUSPB), digital rectal examination, Gleason score (GS) on TRUSPB, percentage of positive cores on TRUSPB, total number of positive cores, highest percentage of cancer in positive cores, and number of lymph nodes removed at RP. Pathological examination of the data of RP specimens, PSA values in follow-up after surgery, and follow-up periods was recorded. The TNM 2009 classification was used for staging. RESULTS: In the evaluation of LNI risk, as regards the assessment of predictors and outcomes with respect to the univariate and multivariate analyses, LNI was found in the univariate analysis to be associated with GS, clinical stage, number of lymph nodes removed according to the D'Amico risk classification. In the multivariate analysis, however, the number of lymph nodes removed was found significant. CONCLUSION: Risk stratification should be considered in patients with prostate cancer while selecting the patients who would undergo pelvic lymphadenectomy. In addition, ePLND should be performed to patients undergoing lymphadenectomy.