Mp37-19 Size of Lymph-Node Metastases in Prostate Cancer Patients Undergoing Radical Prostatectomy: Implication for Imaging and Oncologic Follow-Up of 2705 Lymph-Node Positive Patients

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy I (MP37)1 May 2024MP37-19 SIZE OF LYMPH-NODE METASTASES IN PROSTATE CANCER PATIENTS UNDERGOING RADICAL PROSTATECTOMY: IMPLICATION FOR IMAGING AND ONCOLOGIC FOLLOW-UP OF 2705 LYMPH-NODE POSITIVE PATIENTS Fabian Falkenbach, Mykyta Kachanov, Sami-Ramzi Leyh-Bannurah, Tobias Maurer, Sophie Knipper, Daniel Köhler, Markus Graefen, Guido Sauter, and Lars Budäus Fabian FalkenbachFabian Falkenbach , Mykyta KachanovMykyta Kachanov , Sami-Ramzi Leyh-BannurahSami-Ramzi Leyh-Bannurah , Tobias MaurerTobias Maurer , Sophie KnipperSophie Knipper , Daniel KöhlerDaniel Köhler , Markus GraefenMarkus Graefen , Guido SauterGuido Sauter , and Lars BudäusLars Budäus View All Author Informationhttps://doi.org/10.1097/01.JU.0001008948.02935.01.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Despite modern imaging modalities, the visibility of lymph-node metastases (LNMs) is critically influenced by their size. Aim of the study was to assess the distribution of maximal tumor diameters (i.e., size) in LNMs of pN1-PCa at RP and its impact on visibility in preoperative imaging and oncological outcomes. METHODS: Overall, 2705 consecutive patients with pN1-PCa at RP, harboring a cumulative 7510 LNMs, were analyzed. Descriptive and multivariable analyses addressed the risk of micrometastases (MM)-only disease and the visibility of LNMs. Kaplan-Meier curves and Cox analyses were used for biochemical recurrence-free survival (BCRFS) stratified for MM-only disease. RESULTS: The median LNM size was 4.5 mm (IQR: 2.0-9.0 mm). Of 7510 LNMs, 1966 (26%) were MM (≤2 mm). On preoperative imaging, 526 patients (19%) showed suspicious findings (PSMA-PET/CT: 169/344, 49%). In multivariable analysis, prostate-specific antigen (OR 0.98), age (OR 1.01), a Gleason score >7 at biopsy (OR 0.73), percentage of positive cores at biopsy (OR 0.36), and neoadjuvant treatment (OR 0.51) emerged as independent predictors for less MM-only disease (p<0.05). Patients with MM-only disease compared to those harboring larger LNMs had a longer BCRFS (median 60 versus 29 months, p<0.0001) (Figure 1). CONCLUSIONS: Overall, 26% of LNMs were MM (≤2 mm). Adverse clinical parameters were inversely associated with MM at RP. Consequently, PSMA-PET/CT did not detect a substantial proportion of LNMs and surgical staging remains important in such patients. LNM size impacts oncological prognosis. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e610 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Fabian Falkenbach More articles by this author Mykyta Kachanov More articles by this author Sami-Ramzi Leyh-Bannurah More articles by this author Tobias Maurer More articles by this author Sophie Knipper More articles by this author Daniel Köhler More articles by this author Markus Graefen More articles by this author Guido Sauter More articles by this author Lars Budäus More articles by this author Expand All Advertisement PDF downloadLoading ...