Alessandro Tafuri1,2,3, Nelia Amigoni1, Riccardo Rizzetto1, Marco Sebben1, Aliasger Shakir3, Alessandra Gozzo1, Katia Odorizzi1, Mario De Michele1, Sebastian Gallina1, Alberto Bianchi1, Paola Ornaghi1, Matteo Brunelli4, Vincenzo De Marco1, Vittore Verratti5, Filippo Migliorini1, Maria Angela Cerruto1, Walter Artibani1, Alessandro Antonelli1, Antonio Benito Porcaro6. 1. Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Ospedale Civile Maggiore, Polo Chirurgico Confortini, Piazzale Stefani 1, 37126, Verona, Italy. 2. Department of Neuroscience, Imaging and Clinical Sciences, ‟G. D'Annunzio″ University, Chieti-Pescara, Italy. 3. USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA. 4. Department of Pathology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy. 5. Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy. 6. Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Ospedale Civile Maggiore, Polo Chirurgico Confortini, Piazzale Stefani 1, 37126, Verona, Italy. drporcaro@yahoo.com.
Abstract
OBJECTIVE: To evaluate the association between obesity and risk of multiple lymph node metastases in prostate cancer (PCa) patients with clinically localized EAU intermediate and high-risk classes staged by extended pelvic lymph-node dissection (ePLND) during robot assisted radical prostatectomy (RARP). MATERIALS AND METHODS: 373 consecutive PCa intermediate or high-risk patients were treated by RARP and ePLND. According to pathology results, extension of LNI was classified as absent (pN0 status) or present (pN1 status); pN1 was further categorized as one or more than one (multiple LNI) lymph node metastases. A logistic regression model (univariate and multivariate analysis) was used to evaluate the association between significant categorized clinical factors and the risk of multiple lymph nodes metastases. RESULTS: Overall, after surgery lymph node metastases were detected in 51 patients (13.7%) of whom 22 (5.9%) with more than one metastatic lymph node and 29 (7.8%) with only one positive node. Comparing patients with one positive node to those without, EAU high-risk class only predicted risk of single LNI (OR = 2.872; p = 0.008). The risk of multiple lymph node metastases, when compared to cases without LNI, was independently predicted by BMI ≥ 30 (OR = 6.950; p = 0.002) together with BPC ≥ 50% (OR = 3.910; p = 0.004) and EAU high-risk class (OR = 6.187; p < 0.0001). Among metastatic patients, BMI ≥ 30 was the only factor associated with the risk of multiple LNI (OR = 5.250; p = 0.041). CONCLUSIONS: In patients with clinically localized EAU intermediate and high-risk classes PCa who underwent RARP and ePLND, obesity was a risk factor of multiple LNI.
OBJECTIVE: To evaluate the association between obesity and risk of multiple lymph node metastases in prostate cancer (PCa) patients with clinically localized EAU intermediate and high-risk classes staged by extended pelvic lymph-node dissection (ePLND) during robot assisted radical prostatectomy (RARP). MATERIALS AND METHODS: 373 consecutive PCa intermediate or high-risk patients were treated by RARP and ePLND. According to pathology results, extension of LNI was classified as absent (pN0 status) or present (pN1 status); pN1 was further categorized as one or more than one (multiple LNI) lymph node metastases. A logistic regression model (univariate and multivariate analysis) was used to evaluate the association between significant categorized clinical factors and the risk of multiple lymph nodes metastases. RESULTS: Overall, after surgery lymph node metastases were detected in 51 patients (13.7%) of whom 22 (5.9%) with more than one metastatic lymph node and 29 (7.8%) with only one positive node. Comparing patients with one positive node to those without, EAU high-risk class only predicted risk of single LNI (OR = 2.872; p = 0.008). The risk of multiple lymph node metastases, when compared to cases without LNI, was independently predicted by BMI ≥ 30 (OR = 6.950; p = 0.002) together with BPC ≥ 50% (OR = 3.910; p = 0.004) and EAU high-risk class (OR = 6.187; p < 0.0001). Among metastatic patients, BMI ≥ 30 was the only factor associated with the risk of multiple LNI (OR = 5.250; p = 0.041). CONCLUSIONS: In patients with clinically localized EAU intermediate and high-risk classes PCa who underwent RARP and ePLND, obesity was a risk factor of multiple LNI.
Entities:
Keywords:
Body mass index; Lymph node-invasion; Obesity; Prostate cancer; Robot assisted radical prostatectomy
Authors: Antonio Benito Porcaro; Alessandro Tafuri; Andrea Panunzio; Riccardo Rizzetto; Nelia Amigoni; Clara Cerrato; Aliasger Shakir; Sebastian Gallina; Alberto Bianchi; Francesco Cianflone; Emanuele Serafin; Alessandra Gozzo; Giacomo Di Filippo; Filippo Migliorini; Giovanni Novella; Matteo Brunelli; Maria Angela Cerruto; Alessandro Antonelli Journal: Int Urol Nephrol Date: 2021-09-27 Impact factor: 2.370