Publication:
Oncologic outcomes of lymph node dissection at salvage radical prostatectomy

dc.contributor.coauthorPreisser, Felix
dc.contributor.coauthorIncesu, Reha-Baris
dc.contributor.coauthorRajwa, Pawel
dc.contributor.coauthorChlosta, Marcin
dc.contributor.coauthorAhmed, Mohamed
dc.contributor.coauthorAbreu, Andre Luis
dc.contributor.coauthorCacciamani, Giovanni
dc.contributor.coauthorRibeiro, Luis
dc.contributor.coauthorKretschmer, Alexander
dc.contributor.coauthorWesthofen, Thilo
dc.contributor.coauthorSmith, Joseph A.
dc.contributor.coauthorGraefen, Markus
dc.contributor.coauthorCalleris, Giorgio
dc.contributor.coauthorRaskin, Yannic
dc.contributor.coauthorGontero, Paolo
dc.contributor.coauthorJoniau, Steven
dc.contributor.coauthorSanchez-Salas, Rafael
dc.contributor.coauthorShariat, Shahrokh F.
dc.contributor.coauthorGill, Inderbir
dc.contributor.coauthorKarnes, Robert Jeffrey
dc.contributor.coauthorCathcart, Paul
dc.contributor.coauthorvan der Poel, Henk
dc.contributor.coauthorMarra, Giancarlo
dc.contributor.departmentKUH (Koç University Hospital)
dc.contributor.departmentSchool of Medicine
dc.contributor.kuauthorTilki, Derya
dc.contributor.schoolcollegeinstituteKUH (KOÇ UNIVERSITY HOSPITAL)
dc.contributor.schoolcollegeinstituteSCHOOL OF MEDICINE
dc.date.accessioned2024-12-29T09:40:54Z
dc.date.issued2023
dc.description.abstractSimple Summary: Lymph node invasion represents a poor prognostic factor after primary radical prostatectomy for prostate cancer. However, its impact on oncologic outcomes in salvage radical prostatectomy patients is unknown. Within this study we investigated the impact of lymph node invasion and dissection on the oncologic outcomes after salvage prostatectomy. Our results show that lymph node invasion represents are poor prognostic factor after salvage prostatectomy. Conversely, we recorded no benefit for lymph node dissection compared to no lymph node dissection during salvage prostatectomy. These findings underline the need for a cautious indication of lymph node dissection in salvage prostatectomy patients as well as strict postoperative monitoring of patients with lymph node invasion. Background: Lymph node invasion (LNI) represents a poor prognostic factor after primary radical prostatectomy (RP) for prostate cancer (PCa). However, the impact of LNI on oncologic outcomes in salvage radical prostatectomy (SRP) patients is unknown. Objective: To investigate the impact of lymph node dissection (LND) and pathological lymph node status (pNX vs. pN0 vs. pN1) on long-term oncologic outcomes of SRP patients. Patients and methods: Patients who underwent SRP for recurrent PCa between 2000 and 2021 were identified from 12 high-volume centers. Kaplan-Meier analyses and multivariable Cox regression models were used. Endpoints were biochemical recurrence (BCR), overall survival (OS), and cancer-specific survival (CSS). Results: Of 853 SRP patients, 87% (n = 727) underwent LND, and 21% (n = 151) harbored LNI. The median follow-up was 27 months. The mean number of removed lymph nodes was 13 in the LND cohort. At 72 months after SRP, BCR-free survival was 54% vs. 47% vs. 7.2% for patients with pNX vs. pN0 vs. pN1 (p < 0.001), respectively. At 120 months after SRP, OS rates were 89% vs. 81% vs. 41% (p < 0.001), and CSS rates were 94% vs. 96% vs. 82% (p = 0.02) for patients with pNX vs. pN0 vs. pN1, respectively. In multivariable Cox regression analyses, pN1 status was independently associated with BCR (HR: 1.77, p < 0.001) and death (HR: 2.89, p < 0.001). Conclusions: In SRP patients, LNI represents an independent poor prognostic factor. However, the oncologic benefit of LND in SRP remains debatable. These findings underline the need for a cautious LND indication in SRP patients as well as strict postoperative monitoring of SRP patients with LNI.
dc.description.indexedbyWOS
dc.description.indexedbyScopus
dc.description.indexedbyPubMed
dc.description.issue12
dc.description.openaccessgold, Green Published
dc.description.publisherscopeInternational
dc.description.sponsoredbyTubitakEuN/A
dc.description.volume15
dc.identifier.doi10.3390/cancers15123123
dc.identifier.eissn2072-6694
dc.identifier.quartileQ1
dc.identifier.scopus2-s2.0-85163795686
dc.identifier.urihttps://doi.org/10.3390/cancers15123123
dc.identifier.urihttps://hdl.handle.net/20.500.14288/23484
dc.identifier.wos1014224200001
dc.keywordsSalvage prostatectomy
dc.keywordsBCR
dc.keywordsLymph node dissection
dc.keywordsLymph node invasion
dc.keywordsOncological outcomes
dc.language.isoeng
dc.publisherMDPI
dc.relation.ispartofCancers
dc.subjectOncology
dc.titleOncologic outcomes of lymph node dissection at salvage radical prostatectomy
dc.typeJournal Article
dspace.entity.typePublication
local.contributor.kuauthorTilki, Derya
local.publication.orgunit1SCHOOL OF MEDICINE
local.publication.orgunit1KUH (KOÇ UNIVERSITY HOSPITAL)
local.publication.orgunit2KUH (Koç University Hospital)
local.publication.orgunit2School of Medicine
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