Pd10-03 prognostic impact of lymph vessel invasion in radical prostatectomy patients

You have accessJournal of UrologyCME1 Apr 2023PD10-03 PROGNOSTIC IMPACT OF LYMPH VESSEL INVASION IN RADICAL PROSTATECTOMY PATIENTS Randi Pose, Sophie Knipper, Pierre Tennstedt, Lukas Hohenhorst, Derya Tilki, Guido Sauter, and Markus Graefen Randi PoseRandi Pose More articles by this author , Sophie KnipperSophie Knipper More articles by this author , Pierre TennstedtPierre Tennstedt More articles by this author , Lukas HohenhorstLukas Hohenhorst More articles by this author , Derya TilkiDerya Tilki More articles by this author , Guido SauterGuido Sauter More articles by this author , and Markus GraefenMarkus Graefen More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003250.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Nodal metastasis (N1) is a strong prognostic parameter in prostate cancer (PCa). The oncological outcome of patients without nodal metastases (N0) but with lymphatic invasion (L1) in the prostatectomy specimen seems to be comparable to N1 patients in terms of biochemical recurrence (BCR) according to current literature. Therefore, we retrospectively analysed the influence of L1 on the outcome of the radical prostatectomy (RP) patients. METHODS: We identified 28,945 patients who underwent RP between April 2005 and December 2019 in our tertiary care centre. Of those, 27,329 consecutive patients were analysed. The impact of L1 was measured. The endpoints were BCR, disease progression (metastases) and cancer specific mortality (CSM). RESULTS: Pelvic lymph node dissection was performed in 22,216 patients (81.3%). A median of eleven lymph nodes were dissected (interquartile range (IQR): 4–18). In 3,006 patients (11%) N1 status and in 4,216 patients (15.4%) L1 status was described. The median follow-up was 61 (IQR: 35–97.7) months. We identified 2,278 N0L1 patients, 199 NXL1 patients and 1,739 N1L1 patients. In uni- and multivariable Cox regression models, L1 was an independent predictor for BCR, disease progression and CSM (hazard ratio [HR]=1.43, 1.59 and 1.51; all p<0.008) as well as N status, pT stage, Gleason score and PSA. In Kaplan-Meier analyses, 120-months BCR-free survival, metastases-free survival and cancer-specific survival rates were significantly different between the groups (N0L0, N0L1; NXL0, NX L1; N1L0, N1L1; p<0.001). CONCLUSIONS: L1 has an independent impact on prognosis in PCa patients. Especially, in NX and N0 this might change treatment decisions. This information may prove valuable when risk stratifying based on final pathology Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e326 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Randi Pose More articles by this author Sophie Knipper More articles by this author Pierre Tennstedt More articles by this author Lukas Hohenhorst More articles by this author Derya Tilki More articles by this author Guido Sauter More articles by this author Markus Graefen More articles by this author Expand All Advertisement PDF downloadLoading ...