The role of periprostatic and periseminal vesicle lymph node metastasis in the staging and prognosis of prostate cancer

Subik, M Kristina; Yao, Jorge L.; Sant'Agnese, Paul A. di; Miyamoto, Hiroshi

doi:10.1111/j.1365-2559.2011.04101.x

Cited by 3 publications

(7 citation statements)

References 6 publications

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“…As shown in Kothari et al and others' reports, we confirmed that periprostatic LNs are small lymph nodes identified infrequently in radical prostatectomy specimens. [12][13][14] In this report, we found relatively fewer periprostatic lymph nodes comparing Kothari et al's results. This may be due to the surgeon's skill, in particular the amount of periprostatic tissue obtained.…”

Section: Discussionsupporting

confidence: 53%

“…The incidence of involvement of these lymph nodes by metastasis has been described in only one previous scientific paper and two meeting abstracts. [12][13][14] Based upon these limited data, it appears that patients with metastasis limited to periprostatic LNs have a poor prognosis. However, the enhanced detection of micrometastasis in these lymph nodes and its clinical relevance has not been studied.…”

Section: Introductionmentioning

confidence: 99%

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Periprostatic lymph node metastasis in prostate cancer and its clinical significance

et al. 2012

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Section: Discussionsupporting

confidence: 53%

Section: Introductionmentioning

confidence: 99%

Periprostatic lymph node metastasis in prostate cancer and its clinical significance

et al. 2012

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“…2–4 This is also in line with previous finding of significantly high lymphatic density in the mid-base region, around the ejaculatory ducts. 2,4 We also found 1 case with positive periprostatic LN in the anterior apex. A recent study showed that dissection and careful microscopic examination of anterior fibroadipose tissue revealed small lymph nodes in approximately 17% of patients with an overall metastasis rate of 2.5%.…”

Section: Discussionsupporting

confidence: 91%

“…3,4 Periprostatic LNs are relatively small in size, with an average diameter of 1.2 mm found in the present study and therefore not readily identifiable during gross examination. Extent of sampling during pathological examination of radical prostatectomy could also be a factor in the rate of their identification.…”

Section: Discussioncontrasting

confidence: 64%

Comparison of Biochemical Recurrence–Free Survival Between Periprostatic and Pelvic Lymph Node Metastases of Prostate Cancer

González-Roibón

Han²,

Arslankoz

et al. 2013

Int J Surg Pathol

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Objective To assess the pathologic characteristics and prognostic significance of periprostatic lymph node (LN) metastasis of prostate cancer. The latter was performed by comparing biochemical recurrence (BCR)–free survival in cases of periprostatic LN metastasis versus matched patients showing pelvic LN metastasis Methods and Materials We identified 15 patients who underwent radical prostatectomy in our institution (1984–2011) showing positive periprostatic and negative pelvic LN with available follow-up information (group 1). These patients were matched 1:2 to patients with positive pelvic LN (group 2) for pertinent clinicopathologic parameters. Results Main locations of positive periprostatic LN were posterior base and mid posterolateral. Overall higher rate of positive margins, smaller LN, and metastasis size were encountered in group 1 compared with group 2. At 5 years postprostatectomy, 69% of patients in group 1 were free of BCR, whereas 26% of those in group 2 remained BCR free, suggesting that patients with periprostatic node metastasis appeared to have a lower risk of BCR. However, the difference was not statistically significant (P = .072). The same was true when adjusted for the effect of prostate-specific antigen, surgical margin status, size of LNs, size of metastasis, age, and year of surgery. Conclusion Patients with periprostatic node metastasis may have a lower risk of BCR compared with those with metastasis to pelvic LN. Future analysis of larger cohorts will help establish the biologic significance of prostate cancer metastasis to periprostatic LN.

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“…In the present study, non-pelvic (periprostatic and AFP) LNs were involved in 16.4% of RPs with N1 disease and 0.2% of all RPs (n = 12). Seven were periprostatic LNs, which are small lymph nodes (mean 1.9 mm) found in 0.8-4.4% of RPs and are predominantly located posteriorly/posterolaterally at the base of the prostate or adjacent to the seminal vesicle [46][47][48][49]. Five were AFP LNs; their identification coincided with the beginning of pathological examination of this tissue at our institution in 2010.…”

Section: Discussionmentioning

confidence: 99%

Metastatic potential to regional lymph nodes with Gleason score ≤7, including tertiary pattern 5, at radical prostatectomy

Diolombi

Epstein

2016

BJU International

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This study supports our previous finding that men with GS 6 (GG1) at RP have no risk of LN metastases. These findings also support the 2014 revisions to the Gleason grading system where 3 + 3 with T4 (2005 modified grading system) is now considered 3 + 4 (GG2), with a comment on percent pattern 4, because <5% pattern 4 increases the risk of LN metastases. It also supports keeping 3 + 4 (GG2) with T5 (<5% pattern 5) and 4 + 3 (GG3) with T5 with their respective grade groups, with a notation of T5 because the <5% higher grade component did not increase the risk of LN metastases within a given GG. Our findings highlight that 3 + 4 (GG2) and 4 + 3 (GG3), even with a 5% higher grade component, are distinct groups with respect to LN metastases and should not be combined under the umbrella designation of GS 7 as is often the case in the literature with the Gleason grading system.

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The role of periprostatic and periseminal vesicle lymph node metastasis in the staging and prognosis of prostate cancer

Cited by 3 publications

References 6 publications

Periprostatic lymph node metastasis in prostate cancer and its clinical significance

Periprostatic lymph node metastasis in prostate cancer and its clinical significance

Comparison of Biochemical Recurrence–Free Survival Between Periprostatic and Pelvic Lymph Node Metastases of Prostate Cancer

Metastatic potential to regional lymph nodes with Gleason score ≤7, including tertiary pattern 5, at radical prostatectomy

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