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Original Research

What are the factors that affect the prediction of lymph node metastasis in prostate Cancer?


¹Kaman Devlet Hastanesi Üroloji Bölümü

²Ankara Atatürk Eğitim ve Araştırma Hastanesi 1. Üroloji Kliniği

³Yıldırım Beyazıt Üniversitesi Üroloji Bölümü


DOI :
2012; 7 (1): 47-54

Abstract

Objectives: To analyze the factors that will be effective in pre-dicting lymph node metastasis in patients with prostate cancer

Materials and Methods: Between January 2005 and Febru-ary 2011, a total of 218 patients with prostate cancer had under-gone  radical prostatectomy (RP) and pelvic lymph node dissecti-on (PLND), or  just pelvic lymph node dissection in our clinic were evaluated. Preoperative PSA, patient age, preoperative prostate bi-opsy, clinical stage, final pathology, radiological examinations were evaluated to analyze the factors affecting lymph node invasion.

Results: The average age of the patients were 63.26 ± 6.87 (45-76). The mean PSA value was 13.11 ng/dl and the mean prostate size  defined by TRUSG was 50.2 gr. Lymph node tumor metastasis was detected in postoperative pathological examination of 28 pati-ents including all of the 18 patients who underwent only PLND due to  positive frozen section and 10 of 210 patients who underwent PLND and RP. A higher rate of LNI was detected in tumors located in the basement when the biopsies of the tumor groups were com-pared in terms of location (p=0.047). The highest positive predic-tive accuracy was obtained as 88.1% with the percentage of positi-ve core biopsy and whether the  tumor was single-or double-sided, and followed by 87.60 with the total-PSA and 87.1 with biopsy Gle-ason score. In multivariate analyses, total-PSA, the percentage of the positive cores and the biopsy Gleason scores were found to be significant (p <0.02).

Conclusion: We think our study will be helpful  in selecting pa-tients who will undergo pelvic lymph node dissection.

Key Words: Prostate cancer, lymph node metastasis, lymph node dissection, extended lymph node dissection, PSA, prostate bi-

opsy


Abstract

Objectives: To analyze the factors that will be effective in pre-dicting lymph node metastasis in patients with prostate cancer

Materials and Methods: Between January 2005 and Febru-ary 2011, a total of 218 patients with prostate cancer had under-gone  radical prostatectomy (RP) and pelvic lymph node dissecti-on (PLND), or  just pelvic lymph node dissection in our clinic were evaluated. Preoperative PSA, patient age, preoperative prostate bi-opsy, clinical stage, final pathology, radiological examinations were evaluated to analyze the factors affecting lymph node invasion.

Results: The average age of the patients were 63.26 ± 6.87 (45-76). The mean PSA value was 13.11 ng/dl and the mean prostate size  defined by TRUSG was 50.2 gr. Lymph node tumor metastasis was detected in postoperative pathological examination of 28 pati-ents including all of the 18 patients who underwent only PLND due to  positive frozen section and 10 of 210 patients who underwent PLND and RP. A higher rate of LNI was detected in tumors located in the basement when the biopsies of the tumor groups were com-pared in terms of location (p=0.047). The highest positive predic-tive accuracy was obtained as 88.1% with the percentage of positi-ve core biopsy and whether the  tumor was single-or double-sided, and followed by 87.60 with the total-PSA and 87.1 with biopsy Gle-ason score. In multivariate analyses, total-PSA, the percentage of the positive cores and the biopsy Gleason scores were found to be significant (p <0.02).

Conclusion: We think our study will be helpful  in selecting pa-tients who will undergo pelvic lymph node dissection.

Key Words: Prostate cancer, lymph node metastasis, lymph node dissection, extended lymph node dissection, PSA, prostate bi-

opsy