Mp37-01 Nodal Counts Impact Complication and Lymphocele Rates After Radical Prostatectomy

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy I (MP37)1 May 2024MP37-01 NODAL COUNTS IMPACT COMPLICATION AND LYMPHOCELE RATES AFTER RADICAL PROSTATECTOMY Kevin J. Chua, John Pfail, Alain Kaldany, Alexis Consalvo, Benjamin Lichtbroun, Arnav Srivastava, Hiren V. Patel, Vignesh T. Packiam, Sammy E. Elsamra, David Golombos, Thomas L. Jang, and Saum Ghodoussipour Kevin J. ChuaKevin J. Chua , John PfailJohn Pfail , Alain KaldanyAlain Kaldany , Alexis ConsalvoAlexis Consalvo , Benjamin LichtbrounBenjamin Lichtbroun , Arnav SrivastavaArnav Srivastava , Hiren V. PatelHiren V. Patel , Vignesh T. PackiamVignesh T. Packiam , Sammy E. ElsamraSammy E. Elsamra , David GolombosDavid Golombos , Thomas L. JangThomas L. Jang , and Saum GhodoussipourSaum Ghodoussipour View All Author Informationhttps://doi.org/10.1097/01.JU.0001008948.02935.01.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Pelvic lymphadenectomy during radical prostatectomy (RP) may offer diagnostic value, but extensive dissection may increase complication risk. We aimed to characterize complication rates of RP based on lymph node counts. METHODS: Patients who underwent RP for prostate cancer were identified from the 2019-2021 National Surgical Quality Improvement Program targeted procedural database. We identified patient characteristics and analyzed the association of nodal count and 30-day complications. Multivariable logistic regression was performed with variables including age, T stage, BMI ≥30, ASA Score, neoadjuvant therapy, prior pelvic radiation, prior pelvic surgery, and surgical approach. RESULTS: 14,794 patients underwent RP in the study period. The median number of nodes removed was 5 (IQR 2-11). The 30-day complication rate and lymphocele requiring intervention rate was 11.2% and 0.9%, respectively (Table 1). These rates increased as the number of nodes removed increased (Figure 1). The number needed to harm (lymphoceles requiring intervention) for 1-5, 6-10, 11-15 and 16+ nodes removed was 287, 181, 127 and 71 patients, respectively. On multivariable analysis, the odds for lymphoceles requiring intervention rose with increasing nodal yield (OR 1.18, 95% CI 1.10-1.27 for every 5 nodes removed) (Table 2). CONCLUSIONS: In this large modern cohort, the rate of complications and lymphoceles requiring intervention increases with higher nodal counts during RP. While lymph node yield does not always correlate with extent of lymphadenectomy, this large analysis confirms that thoughtful decision-making regarding extent of lymphadenectomy is needed. Download PPT Source of Funding: This work is supported by a grant from the National Cancer Institute (P30CA072720) © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e601 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Kevin J. Chua More articles by this author John Pfail More articles by this author Alain Kaldany More articles by this author Alexis Consalvo More articles by this author Benjamin Lichtbroun More articles by this author Arnav Srivastava More articles by this author Hiren V. Patel More articles by this author Vignesh T. Packiam More articles by this author Sammy E. Elsamra More articles by this author David Golombos More articles by this author Thomas L. Jang More articles by this author Saum Ghodoussipour More articles by this author Expand All Advertisement PDF downloadLoading ...