6533b820fe1ef96bd12790fa
RESEARCH PRODUCT
Features and management of men with pN1 cM0 prostate cancer after radical prostatectomy and lymphadenectomy: a systematic review of population-based evidence
Christian D. FankhauserClaudia KeschIgor TsaurVeeru KasivisvanathanJonathan OlivierFelix PreisserFabio ZattoniGuillaume PloussardMarco MoschiniIgnacio Puche-sanzIsabel HeideggerPeter Ka-fung ChiuDerya TilkiAlexander KretschmerM. ValerioG. MarraG. MarraFrancesco CeciCharles LaineConstance ThibaultRoderick C.n. Van Den BerghBenjamin PradereGiorgio Gandagliasubject
MaleOncologymedicine.medical_specialtyUrologymedicine.medical_treatmentMedizinpopulation-based studiespositive nodesAndrogen deprivation therapyProstate cancerQuality of lifeInternal medicineHumansMedicineStage (cooking)Lymph nodeAdjuvantNeoplasm StagingRetrospective StudiesProstatectomyRadiotherapybusiness.industryProstatectomyProstatic NeoplasmsAndrogen Antagonistslymph nodeProstate-Specific Antigenprostate cancermedicine.diseaseradical prostatectomyProstate-specific antigenmedicine.anatomical_structurelymph node; population-based studies; positive nodes; prostate cancer; radical prostatectomy; Humans; Lymph Node Excision; Lymphatic Metastasis; Male; Neoplasm Staging; Prostate-Specific Antigen; Prostatectomy; Quality of Life; Radiotherapy Adjuvant; Retrospective Studies; Androgen Antagonists; Prostatic NeoplasmsLymphatic MetastasisQuality of LifeLymph Node ExcisionRadiotherapy AdjuvantLymphadenectomyLymph node; Population-based studies; Positive nodes; Prostate cancer; Radical prostatectomybusinessdescription
Purpose of review To investigate the features and optimal management of pN+ cM0 prostate cancer (PCa) according to registry-based studies. Recent findings Up to 15% of PCa patients harbor lymph node invasion (pN+) at radical prostatectomy plus lymph node dissection. Nonetheless, the optimal management strategy in this setting is not well characterized. Summary We performed a systematic review including n = 13 studies. Management strategies comprised 13 536 men undergoing observation, 11 149 adjuvant androgen deprivation therapy (aADT), 7,075 adjuvant radiotherapy (aRT) +aADT and 705 aRT. Baseline features showed aggressive PCa in the majority of men. At a median follow-up ranging 48-134months, Cancer-related death was 5% and overall-mortality 16.6%. aADT and aRT alone had no cancer-specific survival or overall survival advantages over observation only and over not performing aRT, respectively. aADT plus aRT yielded a survival benefit compared to observation and aADT, which in one study, were limited to certain intermediate-risk categories. Age, Gleason, Charlson score, positive surgical margins, pathological stage, and positive nodes number, but not prostate specific antigen, were most relevant prognostic factors. Our work further confirmed pN+ PCa is a multifaceted disease and will help future research in defining its optimal management based on different risk categories to maximize survival and patient's quality of life.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2021-11-24 | Current Opinion in Urology |