Mp58-13 Long-Term Biochemical Recurrence in Patients With Lymph Node Invasion Undergoing Radical Prostatectomy and Lymph Node Dissection

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy III (MP58)1 May 2024MP58-13 LONG-TERM BIOCHEMICAL RECURRENCE IN PATIENTS WITH LYMPH NODE INVASION UNDERGOING RADICAL PROSTATECTOMY AND LYMPH NODE DISSECTION Felix Preisser, Raisa S. Abrahms-Pompe, Markus Graefen, and Derya Tilki Felix PreisserFelix Preisser , Raisa S. Abrahms-PompeRaisa S. Abrahms-Pompe , Markus GraefenMarkus Graefen , and Derya TilkiDerya Tilki View All Author Informationhttps://doi.org/10.1097/01.JU.0001008852.83523.41.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To assess the probability of long-term biochemical recurrence (BCR)-free survival in patients with lymph node invasion (LNI) during radical prostatectomy (RP) and lymph node dissection (LND). METHODS: Patients with LNI during RP and LND from 1996 to 2017 were identified. Kaplan-Meier analyses and Cox regression models were used to test for the risk of biochemical recurrence (BCR) after RP. Patients with neo-/adjuvant hormone therapy or adjuvant radiotherapy (defined as radiotherapy within the first six months after RP) were excluded. BCR was defined as PSA-value >0.2 ng/ml. RESULTS: Of 16.674 patients with RP and LND, 941 had LNI, 618 (65.7%), 150 (15.9%) and 173 (18.4%) had one, two and three or more positive lymph nodes. Median number of removed lymph nodes was 17 (interquartile range: 11-25). Of patients with available PSA-value in the first three months, 36.4% vs. 63.6% had persistent vs. undetectable PSA after RP. Median follow-up was 37.6 months for patients without BCR and median time to BCR was 32 months. At 60 months after RP, BCR-free survival was 37.8% for the overall cohort, 41.7%, 34.8% and 26.4% for patients with one, two and three or more positive lymph nodes and 48.1% vs 10.1% for patients with undetectable vs. persistent PSA, respectively. In multivariable models, undetectable PSA (HR: 0.17, p<0.001), number of positive lymph nodes (HR: 1.05, p=0.04) and ISUP grade group 4-5 (HR: 1.90, p<0.01) were predictors for BCR. The number of men needed to be treated with LND to prevent one BCR at 60 months was 102. CONCLUSIONS: Patients with LNI during RP have a high-risk of long-term BCR and only few remain free of BCR. A large number of LND procedures is needed to achieve one possible cure in men with lymph node metastasis. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e952 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Felix Preisser More articles by this author Raisa S. Abrahms-Pompe More articles by this author Markus Graefen More articles by this author Derya Tilki More articles by this author Expand All Advertisement PDF downloadLoading ...