Mohamed Gomaa Kamel1,2, Sedralmontaha Istanbuly2,3, Fatma Abd-Elshahed Abd-Elhay1,2, Muawia Yousif Fadlelmola Mohamed2,4, Le Huu-Hoai2,5, Mohamed Sadik2,6, Mahmoud Dibas2,7, Nguyen Tien Huy8,9. 1. Faculty of Medicine, Minia University, Minia, Egypt. 2. Online Research Club, Nagasaki, Japan. 3. Faculty of Medicine, University of Aleppo, Aleppo, Syrian Arab Republic. 4. Faculty of Medicine, University of Khartoum, Khartoum, Sudan. 5. Saigon General Hospital, Ho Chi Minh, Vietnam. 6. Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt. 7. Sulaiman Al Rajhi Colleges, Al Bukayriya, Saudi Arabia. 8. Department of Clinical Product Development, Institute of Tropical Medicine (NEKKEN), School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan, tienhuy@nagasaki-u.ac.jp. 9. Evidence Based Medicine Research Group & Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh, Vietnam, tienhuy@nagasaki-u.ac.jp.
Abstract
BACKGROUND: Prostate cancer (PCa) is the third leading cause of death from cancer in the United States. We aimed to disclose the prognostic values of examined (dissected) lymph node (ELN), negative lymph node (NLN), and positive (metastatic) lymph node (PLN) counts and lymph node (LNs) ratio in PCa patients. METHODS: We extracted data of PCa patients diagnosed between 2004 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) program. We included patients with a histologically confirmed diagnosis having at least one ELN and with the PCa as the primary tumor only. RESULTS: We have included 96,064 patients. Multivariable Cox proportional hazards regression modelsdisclosed that patients having more ELNs were associated with better survival. However, we demonstrated that patients having more PLNs were associated with worse survival. Additionally, older age, unmarried patients, with Gleason's score of 8-10, T4 and M1 stages and those who received chemotherapy and/or radiation but did not receive surgery were significantly associated with worse PCa survival. CONCLUSIONS: We have disclosed several independent predictors affecting PCa patients including age, marital status, Gleason's score, T and N stages, having received therapy, surgery, and ELN and PLN counts. Moreover, we demonstrated that patients with lower ELN and higher PLN counts were a high-risk group. We strongly recommend adding the ELN and/or PLN counts into consideration during patient staging/treatment.
BACKGROUND:Prostate cancer (PCa) is the third leading cause of death from cancer in the United States. We aimed to disclose the prognostic values of examined (dissected) lymph node (ELN), negative lymph node (NLN), and positive (metastatic) lymph node (PLN) counts and lymph node (LNs) ratio in PCapatients. METHODS: We extracted data of PCapatients diagnosed between 2004 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) program. We included patients with a histologically confirmed diagnosis having at least one ELN and with the PCa as the primary tumor only. RESULTS: We have included 96,064 patients. Multivariable Cox proportional hazards regression modelsdisclosed that patients having more ELNs were associated with better survival. However, we demonstrated that patients having more PLNs were associated with worse survival. Additionally, older age, unmarried patients, with Gleason's score of 8-10, T4 and M1 stages and those who received chemotherapy and/or radiation but did not receive surgery were significantly associated with worse PCa survival. CONCLUSIONS: We have disclosed several independent predictors affecting PCapatients including age, marital status, Gleason's score, T and N stages, having received therapy, surgery, and ELN and PLN counts. Moreover, we demonstrated that patients with lower ELN and higher PLN counts were a high-risk group. We strongly recommend adding the ELN and/or PLN counts into consideration during patient staging/treatment.