Laparoscopic Radical Prostatectomy Plus Extended Lymph Node Dissection in Combination With Immediate Androgen Deprivation Therapy for Cases of pT3-4N0-1M0 Prostate Cancer: A Multimodal Study of 8 Years' Follow-up

Yang, Yi; Luo, Yun; Hou, Guoliang; Huang, Qunxiong; Pang, Jun; Gao, Xin

doi:10.1016/j.clgc.2015.11.009

Cited by 4 publications

(2 citation statements)

References 30 publications

(32 reference statements)

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“…In our pT3b cohort also, PSM was not found as a prognostic factor in univariate and multivariate analysis. As in the study of Yang et al [23] where Kaplan-Meier analysis stratified by CAPRA-S scores of 3-5 vs. ≥ 6 resulted in differences among groups, in our cohort BCRFS rates also decreased with increasing Capra-S score. The 5-year BCRFS was higher in pT3b patients with Capra-S scores 3-5 vs. ≥6, but log-rank test (x2(1)=2.57, p=0.109) did not reveal statistically significant differences among the groups.…”

Section: Discussionsupporting

confidence: 81%

Prognostic variables associated with biochemical recurrence following radical prostatectomy for pT3b prostate cancer: a research study

et al. 2018

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The objectives of the current study were to determine long-term biochemical recurrence rates stratified by adverse pathologic features and to identify predictive factors of biochemical recurrence rates following radical prostatectomy performed by either retropubic prostatectomy or robot-assisted laparoscopic prostatectomy from single tertiary center prostate cancer database.Material and Methods: The Seoul National University Hospital prostate cancer database was queried for all patients treated with radical prostatectomy from 1999 to 2015. Among the 2680 patients who underwent radical prostatectomy, 331 patients with seminal vesicle invasion (pathologic T3bN0-1M0 stage) were identified. The primary endpoint was biochemical recurrence, defined as two consecutive postoperative prostate specific antigen values ≥0.2 ng/ml. Comparative analysis based on adverse pathologic characteristics and operation type was performed.Results: Five and 10-year biochemical recurrence-free survival in the entire cohort was 59.0% and 42.9%. The Kaplan-Meier survival analysis demonstrated 5-year biochemical recurrence free survival rates differences in patients with different lymph node involvement (70.6% vs. 52.4%, log-rank, p=0.01). Variables including age, extracapsular extension, lymph node invasion, surgical margin, perineural invasion, multicentricity and Capra-S score were similar between the groups of patients who underwent either retropubic or robot-assisted laparoscopic radical prostatectomy. The mean prostate specific antigen level, seminal vesicle invasion laterality, tumor volume, and pathologic Gleason score were lower in the cohort of patients who underwent robot-assisted laparoscopic prostatectomy. No statistically significant differences were found in 5-year biochemical recurrence-free survival rates stratified by operation type (58.1% vs. 65%, log-rank, p=0.8), by Capra-S score (72.5% vs. 56.8%, log rank, p=0.1), or by surgical margin status (69.4% vs. 59.3%, log-rank, p=0.8). In univariate and multivariate Cox proportional regression analysis lymph node involvement (p=0.01) was found to be a statistically significant predictor of biochemical recurrence. Conclusion:Patients with positive lymph node involvement have a poor prognosis. Capra-S score was unable to predict biochemical recurrence in patients with pathologic T3b stage prostate cancer. Robot-assisted laparoscopic prostatectomy is comparable to retropubic radical prostatectomy in terms of the biochemical progression of prostate cancer with seminal vesicle invasion.

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Section: Discussionsupporting

confidence: 81%

Prognostic variables associated with biochemical recurrence following radical prostatectomy for pT3b prostate cancer: a research study

et al. 2018

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“…These studies reported that aDT could achieve downstaging, recent years the therapeutic scenario of Pca has changed and the interest in studies on neoadjuvant treatments could be renewed. indeed, the surgical indication for locally advanced 42 and even oligo-metastatic Pca, 43 within a multimodal strategy, 44,45 is expanding and for these patients aDT prior to surgery is frequently practiced. Moreover, the advent of new hormonal molecules as degarelix, abiraterone, and enzalutamide stimulated the interest in studies in neoadjuvant setting.…”

Section: Discussionmentioning

confidence: 99%

Biological effect of neoadjuvant androgen-deprivation therapy assessed on specimens from radical prostatectomy: a systematic review

Antonelli

Palumbo

Veccia

et al. 2018

Minerva Urol Nefrol

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Therapeutic Value of Standard Versus Extended Pelvic Lymph Node Dissection During Radical Prostatectomy for High-Risk Prostate Cancer

Colicchia

Abdollah

et al. 2017

Curr Urol Rep

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Extent of pelvic lymph node dissection (PLND) during radical prostatectomy (RP) remains a subject of debate. Here, we review the literature covering the value of extended PLND (ePLND) during RP for high-risk prostate cancer (PCa) over a standard PLND, with a focus on potential therapeutic advantage. PLND may provide valuable prognostic information to high-risk PCa patients, and incorporating the common iliac and presacral nodes to ePLND templates further improves pathologic nodal staging accuracy. Although increased PLND extent is associated with increased lymphocele/lymphedema rates, it is not associated with increased venous thromboembolism rates. The therapeutic role of ePLND remains uncertain. While recent retrospective studies suggest an increased number of nodes removed within the ePLND template are associated with improved survival outcomes, such retrospective studies cannot completely adjust for the Will Rodgers phenomenon or surgeon-specific factors. Thus, the results of randomized trials are eagerly awaited in this arena.

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Laparoscopic Radical Prostatectomy Plus Extended Lymph Node Dissection in Combination With Immediate Androgen Deprivation Therapy for Cases of pT3-4N0-1M0 Prostate Cancer: A Multimodal Study of 8 Years' Follow-up

Abstract: LRP plus ePLND in combination with immediate androgen deprivation therapy is a feasible approach to patients with pT3-4N0-1M0 PCa; favorable functional and oncologic outcomes were presented postoperatively.

Cited by 4 publications

References 30 publications

Prognostic variables associated with biochemical recurrence following radical prostatectomy for pT3b prostate cancer: a research study

Prognostic variables associated with biochemical recurrence following radical prostatectomy for pT3b prostate cancer: a research study

Biological effect of neoadjuvant androgen-deprivation therapy assessed on specimens from radical prostatectomy: a systematic review

Therapeutic Value of Standard Versus Extended Pelvic Lymph Node Dissection During Radical Prostatectomy for High-Risk Prostate Cancer

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