PD54-05 HALSTEADIAN VIEW OF PROSTATE CANCER: DOES REMOVING MORE NODES AT RADICAL PROSTATECTOMY AFFECT BIOCHEMICAL RECURRENCE?

You have accessJournal of UrologyCME1 May 2022PD54-05 HALSTEADIAN VIEW OF PROSTATE CANCER: DOES REMOVING MORE NODES AT RADICAL PROSTATECTOMY AFFECT BIOCHEMICAL RECURRENCE? Lior Taich, Lin Gu, Christopher L. Amling, William J. Aronson, Matthew R. Cooperberg, Lourdes G. Rivera, Christopher J. Kane, Zachary Klassen, Martha K. Terris, and Stephen Freedland Lior TaichLior Taich More articles by this author , Lin GuLin Gu More articles by this author , Christopher L. AmlingChristopher L. Amling More articles by this author , William J. AronsonWilliam J. Aronson More articles by this author , Matthew R. CooperbergMatthew R. Cooperberg More articles by this author , Lourdes G. RiveraLourdes G. Rivera More articles by this author , Christopher J. KaneChristopher J. Kane More articles by this author , Zachary KlassenZachary Klassen More articles by this author , Martha K. TerrisMartha K. Terris More articles by this author , and Stephen FreedlandStephen Freedland More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002631.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The extent of lymph node dissection during radical prostatectomy (RP) is a long debated issue. Most recently in prostate cancer, standard vs. extended lymph node dissection was evaluated in a randomized control trial, yet the both groups had a high number of nodes removed and varied by only 2 nodes (12 vs. 14). We evaluated whether more nodes taken at RP was associated with better outcomes in a Veteran Affairs (VA) population. METHODS: The shared equal access regional cancer hospital (SEARCH) database was queried for patients diagnosed with prostate cancer who underwent RP between 2000-2020. Patients were excluded if they underwent neoadjuvant therapy, did not have lymph nodes removed at time of surgery, or did not have PSA data after surgery. Number of lymph nodes removed was treated as a continuous variable. Hazard Ratios (HRs) and 95% confidence intervals (CIs) of biochemical recurrence (BCR), overall survival (OS), metastasis, castrate resistant prostate cancer (CRPC), and prostate cancer specific mortality (PCSM) were estimated using Cox proportional hazard method adjusting for age, race, surgical year, Charlson comorbidity index (CCI), biopsy Gleason score, and log-transformed PSA. RESULTS: 4,255 patients were included in the analysis. The average age was 63 and average PSA was 9.5. White men comprised 70% of the dataset, Black men represented 26%, and 4% were Other. There were 9 lymph nodes removed on average, with biopsy Gleason <6 having 7 removed, Gleason 3+4 and 4+3 had 9 removed, and 11 nodes were removed in Gleason 8-10 (p <0.001). The number of lymph nodes removed did not have a statistically significant impact on BCR (HR 0.99, 95% CI 0.99-1.00, p=0.126), or on OS, metastasis, CRPC, or PCSM. CONCLUSIONS: The extent of lymph node dissection during RP seen in the SEARCH cohort is in line with prior literature, and predictably, patients with more aggressive disease had more nodes removed. In our real world dataset, removing more lymph nodes at RP did not improve BCR or survival. These data suggest that an extended lymph node dissection may provide more diagnostic utility than therapeutic benefit. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e917 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lior Taich More articles by this author Lin Gu More articles by this author Christopher L. Amling More articles by this author William J. Aronson More articles by this author Matthew R. Cooperberg More articles by this author Lourdes G. Rivera More articles by this author Christopher J. Kane More articles by this author Zachary Klassen More articles by this author Martha K. Terris More articles by this author Stephen Freedland More articles by this author Expand All Advertisement PDF DownloadLoading ...