A.A. Cayetano-Alcaraz, M. Sotomayor-de-Zavaleta, R.A. Castillejos-Molina, F. Gabilondo-Navarro, G. Feria-Bernal, F.T. Rodríguez-Covarrubias
{"title":"根治性前列腺切除术后N1疾病的肿瘤结果","authors":"A.A. Cayetano-Alcaraz, M. Sotomayor-de-Zavaleta, R.A. Castillejos-Molina, F. Gabilondo-Navarro, G. Feria-Bernal, F.T. Rodríguez-Covarrubias","doi":"10.1016/j.uromx.2015.11.004","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Radical prostatectomy<!--> <!-->+<!--> <!-->pelvic lymph node dissection can improve progression-free survival and cancer-specific survival in lymph node disease.</p></div><div><h3>Aim</h3><p>To analyze the characteristics of patients with lymph node disease in the histopathologic findings of the radical prostatectomy and lymph node dissection.</p></div><div><h3>Material and methods</h3><p>A retrospective study was carried out on patients that underwent radical prostatectomy with metastatic lymph node disease within the time frame of 1988 to 2015.</p></div><div><h3>Results</h3><p>The study included 25 patients with a mean 66.5 years of age (SD<!--> <!-->±<!--> <!-->6.5), a mean prostate-specific antigen of 20.17<!--> <!-->ng/dl (IQR: 18), and a median follow-up period of 63 months (IQR: 86). According to the D’Amico classification, 15 (60%) patients were high-risk, 8 (32%) were intermediate-risk, and 2 (8%) were low-risk. Positive margins were found in 15 cases (60%); 4 (16%) patients had T2 tumor stage, 3 (12%) had T3A, 17 (68%) had T3B, and one patient (4%) had T4. Fourteen (56%) patients had one positive lymph node, 3 (12%) patients had 2 positive lymph nodes, and 8 (32%) patients had more than 2 positive lymph nodes. Three (16%) patients received radiotherapy and 24 (96%) underwent hormone blockade. Progression-free survival was 105 months and cancer-specific survival was 86% at 5 years and 45% at ten years. The HR for biochemical progression was significant in positive margins (HR: 9.5, 95% CI: 0.99-91.5, <em>P</em> <!-->=<!--> <!-->.50) and when there were<!--> <!-->≥<!--> <!-->2 positive lymph nodes (HR: 8.5, 95% CI: 1.1-61.9, <em>P</em> <!-->=<!--> <!-->0.34). Involvement of<!--> <!-->≥<!--> <!-->2 lymph nodes predicted progression with an odds ratio of 7.2 (95% CI: 1.06-48.6, <em>P</em> <!-->=<!--> <!-->.043).</p></div><div><h3>Conclusions</h3><p>The average 5-year survival was above 80%. The number of positive lymph nodes could be a predictive factor for biochemical progression.</p></div>","PeriodicalId":34909,"journal":{"name":"Revista mexicana de urologia","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.uromx.2015.11.004","citationCount":"0","resultStr":"{\"title\":\"Resultados oncológicos en enfermedad N1 posterior a la prostatectomía radical\",\"authors\":\"A.A. Cayetano-Alcaraz, M. Sotomayor-de-Zavaleta, R.A. Castillejos-Molina, F. Gabilondo-Navarro, G. Feria-Bernal, F.T. Rodríguez-Covarrubias\",\"doi\":\"10.1016/j.uromx.2015.11.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Radical prostatectomy<!--> <!-->+<!--> <!-->pelvic lymph node dissection can improve progression-free survival and cancer-specific survival in lymph node disease.</p></div><div><h3>Aim</h3><p>To analyze the characteristics of patients with lymph node disease in the histopathologic findings of the radical prostatectomy and lymph node dissection.</p></div><div><h3>Material and methods</h3><p>A retrospective study was carried out on patients that underwent radical prostatectomy with metastatic lymph node disease within the time frame of 1988 to 2015.</p></div><div><h3>Results</h3><p>The study included 25 patients with a mean 66.5 years of age (SD<!--> <!-->±<!--> <!-->6.5), a mean prostate-specific antigen of 20.17<!--> <!-->ng/dl (IQR: 18), and a median follow-up period of 63 months (IQR: 86). According to the D’Amico classification, 15 (60%) patients were high-risk, 8 (32%) were intermediate-risk, and 2 (8%) were low-risk. Positive margins were found in 15 cases (60%); 4 (16%) patients had T2 tumor stage, 3 (12%) had T3A, 17 (68%) had T3B, and one patient (4%) had T4. Fourteen (56%) patients had one positive lymph node, 3 (12%) patients had 2 positive lymph nodes, and 8 (32%) patients had more than 2 positive lymph nodes. Three (16%) patients received radiotherapy and 24 (96%) underwent hormone blockade. Progression-free survival was 105 months and cancer-specific survival was 86% at 5 years and 45% at ten years. The HR for biochemical progression was significant in positive margins (HR: 9.5, 95% CI: 0.99-91.5, <em>P</em> <!-->=<!--> <!-->.50) and when there were<!--> <!-->≥<!--> <!-->2 positive lymph nodes (HR: 8.5, 95% CI: 1.1-61.9, <em>P</em> <!-->=<!--> <!-->0.34). Involvement of<!--> <!-->≥<!--> <!-->2 lymph nodes predicted progression with an odds ratio of 7.2 (95% CI: 1.06-48.6, <em>P</em> <!-->=<!--> <!-->.043).</p></div><div><h3>Conclusions</h3><p>The average 5-year survival was above 80%. The number of positive lymph nodes could be a predictive factor for biochemical progression.</p></div>\",\"PeriodicalId\":34909,\"journal\":{\"name\":\"Revista mexicana de urologia\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2016-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/j.uromx.2015.11.004\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Revista mexicana de urologia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2007408515001445\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista mexicana de urologia","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2007408515001445","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
Resultados oncológicos en enfermedad N1 posterior a la prostatectomía radical
Background
Radical prostatectomy + pelvic lymph node dissection can improve progression-free survival and cancer-specific survival in lymph node disease.
Aim
To analyze the characteristics of patients with lymph node disease in the histopathologic findings of the radical prostatectomy and lymph node dissection.
Material and methods
A retrospective study was carried out on patients that underwent radical prostatectomy with metastatic lymph node disease within the time frame of 1988 to 2015.
Results
The study included 25 patients with a mean 66.5 years of age (SD ± 6.5), a mean prostate-specific antigen of 20.17 ng/dl (IQR: 18), and a median follow-up period of 63 months (IQR: 86). According to the D’Amico classification, 15 (60%) patients were high-risk, 8 (32%) were intermediate-risk, and 2 (8%) were low-risk. Positive margins were found in 15 cases (60%); 4 (16%) patients had T2 tumor stage, 3 (12%) had T3A, 17 (68%) had T3B, and one patient (4%) had T4. Fourteen (56%) patients had one positive lymph node, 3 (12%) patients had 2 positive lymph nodes, and 8 (32%) patients had more than 2 positive lymph nodes. Three (16%) patients received radiotherapy and 24 (96%) underwent hormone blockade. Progression-free survival was 105 months and cancer-specific survival was 86% at 5 years and 45% at ten years. The HR for biochemical progression was significant in positive margins (HR: 9.5, 95% CI: 0.99-91.5, P = .50) and when there were ≥ 2 positive lymph nodes (HR: 8.5, 95% CI: 1.1-61.9, P = 0.34). Involvement of ≥ 2 lymph nodes predicted progression with an odds ratio of 7.2 (95% CI: 1.06-48.6, P = .043).
Conclusions
The average 5-year survival was above 80%. The number of positive lymph nodes could be a predictive factor for biochemical progression.
期刊介绍:
Revista Mexicana de Urología (RMU) [Mexican Journal of Urology] (ISSN: 0185-4542 / ISSN electronic: 2007-4085) is bimonthly publication that disseminates research by academicians and professionals of the international medical community interested in urological subjects, in the format of original articles, clinical cases, review articles brief communications and letters to the editor. Owing to its nature, it is publication with international scope that disseminates contributions in Spanish and English that are rigorously reviewed by peers under the double blind modality. Neither journalistic documents nor those that lack rigorous medical or scientific support are suitable for publication.