Current status of lymph node‐positive prostate cancer

Swanson, Gregory P.; Thompson, Ian M.; Basler, Joseph W.

doi:10.1002/cncr.22034

Cited by 58 publications

(39 citation statements)

References 114 publications

(107 reference statements)

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“…Development of screening techniques has reduced the incidence of prostate cancers (PCa) that have already spread to neighboring lymph nodes (LN+) from about 40% to <10% in the last 50 years [1]. However, this still accounts for about 22,000 new cases each year in the US alone [2].…”

Section: Introductionmentioning

confidence: 99%

Stratifying prostate cancer patients by relative lymph node involvement: population‐ and modeling‐based study

2016

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It is estimated that about 10% of new prostate cancer (PCa) cases are lymph node‐positive (LN+). We have previously discussed the role of the inflection point (IP) of an inverse Gompertzian survival curve as a surrogate for disease incurability. In this study, we aimed to stratify curability of different patient cohorts with pathologically positive lymph nodes through modeling survival curves by different percentages of LN involvement (%LN+) postoperatively and calculating associated IPs. From the Surveillance, Epidemiology, and End Results (SEER) database, we selected LN+ PCa patients undergoing radical prostatectomy. Modeling of relative survival curves using inverse Gompertzian kinetics for increasing value of maximal %LN+ involvement allowed stratification of cohort into groups with <10%, 10–40%, and greater or equal to 40% of LN+ out of all LNs sampled. Data were retrieved for 5903 patients. For the entire cohort, relative survival was 96%, 87%, and 76% at 5, 10, and 15 years, respectively. For %LN +, <10% the IP was about 27 years postoperatively. Patients with 10–40% LN+ had an IP at about 10 years; for those with more than 40% LN+, the IP was 7 years. A 10‐year relative survival decreases from 97% for <10% LN+ to 71% for more than 40% LN+. While better therapies for LN + PCa are badly needed, this patient cadre is not homogenous and should be stratified by %LN+ in future clinical trials.

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Section: Introductionmentioning

confidence: 99%

Stratifying prostate cancer patients by relative lymph node involvement: population‐ and modeling‐based study

2016

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“…However, although patients with localized tumor can be effectively treated with f100% 5-year relative survival (3), prognostic indicators are not indicative of clinical outcome for those patients with late-stage metastatic disease. Even those patients diagnosed early in their disease course may still have micrometastasis, leading to secondary tumor growth (4). This progression of solid tumors to metastatic disease includes essential steps that involve the detachment of cells from the surrounding extracellular matrix, tumor cell survival in the circulation, and tissue invasion (5,6).…”

Section: Introductionmentioning

confidence: 99%

Targeting CUB Domain-Containing Protein 1 with a Monoclonal Antibody Inhibits Metastasis in a Prostate Cancer Model

et al. 2008

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Through a whole-cell panning approach, we previously identified a panel of antibodies that bound to prostate cancer cell surface antigens. One such antigen, CUB domain-containing protein 1 (CDCP1), was recognized by monoclonal antibody 25A11 and is a single transmembrane molecule highly expressed in several metastatic cancers as well as on CD34 + CD133+ myeloid leukemic blast cells. We show CDCP1 expression on prostate cancer cell lines by real-time quantitative PCR (RT-qPCR), flow cytometry, and immunohistochemistry and on prostate cancer patient samples by RT-qPCR and immunohistochemical staining. In cell-based assays, antibody 25A11 inhibited prostate cancer cell migration and invasion in vitro. Further characterization showed that CDCP1 is internalized on antibody binding. When 25A11 was coupled to the cytotoxin saporin either directly or via a secondary antibody, both resulted in prostate cancer cell killing in vitro. In vivo targeting studies with an anti-CDCP1 immunotoxin showed significant inhibition of primary tumor growth as well as metastasis in a mouse xenograft model. These data provide support for continued evaluation of anti-CDCP1 therapy for potential use in cancer in primary and metastatic disease.

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“…This contrasts with a reported risk of LN disease of > 10% in older RP series in the PSA era [ 14 ] . Over time, the widespread use of PSA testing for the early diagnosis of prostate cancer has led to a welldocumented stage migration, including a decrease in rates of LN metastasis at diagnosis.…”

Section: Discussionmentioning

confidence: 58%

“…The clinical determinants of LN metastases of prostate cancer are the well-known risk factors of c-stage, biopsy Gleason score, serum PSA concentration and PPC [ 14,17 ] . In keeping with this, the present study shows a strong univariate relationship between the risk of LN disease and each of the last three risk factors.…”

Section: Discussionmentioning

confidence: 99%

Algorithm for selecting men for pelvic lymph node dissection (PLND) during radical prostatectomy based on clinical risk factors in an Australian population

et al. 2012

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OBJECTIVE• To defi ne selection criteria for pelvic lymph node dissection (PLND) based on a contemporary Australian cohort of men with clinically localised prostate cancer undergoing radical prostatectomy (RP) with PLND, as stage migration of prostate cancer has led to re-evaluation of the role of PLND at the time of RP. • The clinical and pathological data were extracted by retrospective chart review. PATIENTS AND METHODS •• Associations between clinical predictors and LN positivity were assessed by logistic regression analysis. RESULTS• Overall, there were LN metastases were in 10 (5%) men.• The LN positivity rate was signifi cantly associated with biopsy Gleason score, preoperative prostate-specifi c antigen (PSA) concentration and percentage of positive cores (PPC), with respective odds ratios (OR) (95% confi dence interval [ CI ] ) of 3.70 (1.98 -6.92), 1.11 (1.04 -1.19) and 1.04 (1.01 -1.06) • Trend toward signifi cant association with clinical stage (OR 1.75, 95% CI 0.97 -3.13) • On multivariate analysis, PSA concentraion and biopsy Gleason score were signifi cant predictors of LN disease.• All 10 men with LN metastases came from a high-risk group of 96, identifi able by having at least one of the following: stage ≥ cT2b, biopsy Gleason score ≥ 4 + 3, PSA concentration of ≥ 10 ng/mL or PPC of ≥ 38%. CONCLUSIONS• The risk of LN metastases depends upon well-defi ned clinical risk factors of stage, biopsy Gleason score, PSA concentration and PPC • The present data suggests a simple risk-stratifi cation method, using these risk factors, of identifying men to have PLND at the time of RP KEYWORDS prostate cancer , lymph node dissection , radical prostatectomy , algorithm , selection of patients

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Current status of lymph node‐positive prostate cancer

Cited by 58 publications

References 114 publications

Stratifying prostate cancer patients by relative lymph node involvement: population‐ and modeling‐based study

Stratifying prostate cancer patients by relative lymph node involvement: population‐ and modeling‐based study

Targeting CUB Domain-Containing Protein 1 with a Monoclonal Antibody Inhibits Metastasis in a Prostate Cancer Model

Algorithm for selecting men for pelvic lymph node dissection (PLND) during radical prostatectomy based on clinical risk factors in an Australian population

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