MAAUA 68th Annual Meeting Abstracts
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Omission of Pelvic Lymphadenectomy in Low-Risk Prostate Cancer Patients is Not Associated with Higher Rates of Biochemical Recurrence at Five Years
Joshua E Logan, Michael D Fabrizio, Robert W Given, Stephen B Riggs, Raymond S Lance
Eastern Virginia Medical School, Norfolk, VA
Introduction:
Several studies have reported a very low incidence of lymph node metastasis in D’Amico low-risk prostate cancer. Omission of the pelvic lymphadenectomy (PLND) has increased in this group. We evaluated whether omission of a PLND in these patients was associated with increased rates of biochemical recurrence (BCR) with long follow-up.
Materials & Methods:
The study population included 211 patients with prostate cancer clinical stage T1-2, Gleason 3+3, and PSA <10ng/ml. Patients were divided into two groups, those with PLND (+PL) at the time of prostatectomy (n = 88) and those without (-PL) (n = 123). BCR was defined as PSA >0.2ng/ml within five years of surgery. Cox proportional hazards analysis was applied to evaluate the association between omission of PLND and BCR.
Results:
Median follow-up was 74.4 months. On Cox proportional hazards analysis omission of PLND was not a predictor of biochemical recurrence in -PL when compared to +PL (p = 0.30). Other variables assessed and found not to be predictive of biochemical recurrence were: year of surgery (p = 0.44); age at surgery (p = 0.23); African-American race (p = 0.10); cT2 stage (p = 0.16); number of biopsy cores (p = 0.52); number of positive biopsy cores (p = 0.39); and percent positive cores (p = 0.62). PSA was the only pre-operative clinical variable found to predict BCR (p = 0.004).
Conclusions:
With long-term follow-up, D’Amico low-risk prostate cancers are no more likely to develop BCR when PLND is omitted than those who undergo PLND.
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