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Validation study on the 2 mm diameter cutoff in lymph node‐positive cases following radical prostatectomy in accordance with the AJCC/UICC TNM 8th edition: Real‐world data analysis from a Japanese cohort.
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- Author(s): Kato, Masashi (AUTHOR); Shiota, Masaki (AUTHOR); Kimura, Takahiro (AUTHOR); Hanazawa, Ryoichi (AUTHOR); Hirakawa, Akihiro (AUTHOR); Takamatsu, Dai (AUTHOR); Tashiro, Kojiro (AUTHOR); Matsui, Yoshiyuki (AUTHOR); Hashine, Katsuyoshi (AUTHOR); Saito, Ryoichi (AUTHOR); Yokomizo, Akira (AUTHOR); Yamamoto, Yoshiyuki (AUTHOR); Narita, Shintaro (AUTHOR); Hashimoto, Kohei (AUTHOR); Matsumoto, Hiroaki (AUTHOR); Akamatsu, Shusuke (AUTHOR); Nishiyama, Naotaka (AUTHOR); Eto, Masatoshi (AUTHOR); Kitamura, Hiroshi (AUTHOR); Tsuzuki, Toyonori (AUTHOR)
- Source:
International Journal of Urology. Jun2024, Vol. 31 Issue 6, p662-669. 8p. - Source:
- Additional Information
- Subject Terms:
- Abstract: Objectives: The American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) 8th edition has proposed micrometastasis as a lymph node metastasis (LN+) of diameter ≤2 mm in prostate cancer. However, supporting evidence has not described. We evaluated LN+ patients' survival after radical prostatectomy (RP) based on the LN maximum tumor diameter (MTD). Methods: Data from 561 LN+ patients after RP and pelvic LN dissection (PLND) treated between 2006 and 2019 at 33 institutions were retrospectively investigated. Patients were stratified by a LN+ MTD cutoff of 2 mm. Outcomes included castration resistance‐free survival (CRFS), metastasis‐free survival (MFS), cancer‐specific survival (CSS), and overall survival (OS). Results: In total, 282 patients were divided into two groups (LN+ MTD >2 mm [n = 206] and ≤2 mm [n = 76]). Patients of LN+ status >2 mm exhibited significantly decreased CRFS and MFS, and poorer CSS and OS. No patients developed CRPC in the LN+ status ≤2 mm group when the PLND number was ≥14. Multivariate analysis showed the number of LN removed, RP Gleason pattern 5, and MTD in LN+ significantly predicted CRFS. Conclusions: Patients of LN+ status ≤2 mm showed better prognoses after RP. In all the patients in the ≤2‐mm group, the progression to CRPC could be prevented with appropriate interventions, particularly when PLND is performed accurately. Our findings support the utility of the pN substaging proposed by the AJCC/UICC 8th edition; this will facilitate precision medicine for patients with advanced prostate cancer. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of International Journal of Urology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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