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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2024

14-02-2024 | Prostatectomy | Urologic Oncology

Prognostication in Lymph Node-Positive Prostate Cancer with No PSA Persistence After Radical Prostatectomy

Authors: Masaki Shiota, MD, PhD, Dai Takamatsu, MD, PhD, Yoshiyuki Matsui, MD, PhD, Akira Yokomizo, MD, PhD, Shuichi Morizane, MD, PhD, Ryoichi Saito, MD, PhD, Makito Miyake, MD, PhD, Masakazu Tsutsumi, MD, PhD, Yoshiyuki Yamamoto, MD, PhD, Kojiro Tashiro, MD, PhD, Ryotaro Tomida, MD, Shintaro Narita, MD, PhD, Kohei Edamura, MD, PhD, Takahiro Yamaguchi, MD, PhD, Kohei Hashimoto, MD, PhD, Masashi Kato, MD, PhD, Takashi Kasahara, MD, PhD, Takayuki Yoshino, MD, PhD, Shusuke Akamatsu, MD, PhD, Tomoyuki Kaneko, MD, PhD, Akihiro Matsukawa, MD, Ryuji Matsumoto, MD, PhD, Akira Joraku, MD, PhD, Toshihiro Saito, MD, PhD, Takuma Kato, MD, PhD, Manabu Kato, MD, PhD, Hideki Enokida, MD, PhD, Shinichi Sakamoto, MD, PhD, Naoki Terada, MD, PhD, Hidenori Kanno, MD, PhD, Naotaka Nishiyama, MD, PhD, Takahiro Kimura, MD, PhD, Hiroshi Kitamura, MD, PhD, Masatoshi Eto, MD, PhD, the Japanese Urological Oncology Group

Published in: Annals of Surgical Oncology | Issue 6/2024

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Abstract

Background

This study aimed to create a prognostic model to predict disease recurrence among patients with lymph node involvement but no prostate-specific antigen (PSA) persistence and to explore its clinical utility.

Methods

The study analyzed patients with lymph node involvement after pelvic lymph node dissection with radical prostatectomy in whom no PSA persistence was observed between 2006 and 2019 at 33 institutions. Prognostic factors for recurrence-free survival (RFS) were analyzed by the Cox proportional hazards model.

Results

Among 231 patients, 127 experienced disease recurrence. The factors prognostic for RFS were PSA level at diagnosis (≥ 20 vs. < 20 ng/mL: hazard ratio [HR], 1.66; 95% confidence interval [CI], 1.09–2.52; P = 0.017), International Society of Urological Pathology grade group at radical prostatectomy (RP) specimen (group ≥ 4 vs. ≤ 3: HR, 1.63; 95% CI 1.12–2.37; P = 0.010), pathologic T-stage (pT3b/4 vs. pT2/3a: HR, 1.70; 95% CI 1.20–2.42; P = 0.0031), and surgical margin status (positive vs. negative: HR, 1.60; 95% CI 1.13–2.28; P = 0.0086). The prognostic model using four parameters were associated with RFS and metastasis-free survival.

Conclusion

The prognostic model in combination with postoperative PSA value and number of lymph nodes is clinically useful for discussing treatment choice with patients.
Appendix
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Metadata
Title
Prognostication in Lymph Node-Positive Prostate Cancer with No PSA Persistence After Radical Prostatectomy
Authors
Masaki Shiota, MD, PhD
Dai Takamatsu, MD, PhD
Yoshiyuki Matsui, MD, PhD
Akira Yokomizo, MD, PhD
Shuichi Morizane, MD, PhD
Ryoichi Saito, MD, PhD
Makito Miyake, MD, PhD
Masakazu Tsutsumi, MD, PhD
Yoshiyuki Yamamoto, MD, PhD
Kojiro Tashiro, MD, PhD
Ryotaro Tomida, MD
Shintaro Narita, MD, PhD
Kohei Edamura, MD, PhD
Takahiro Yamaguchi, MD, PhD
Kohei Hashimoto, MD, PhD
Masashi Kato, MD, PhD
Takashi Kasahara, MD, PhD
Takayuki Yoshino, MD, PhD
Shusuke Akamatsu, MD, PhD
Tomoyuki Kaneko, MD, PhD
Akihiro Matsukawa, MD
Ryuji Matsumoto, MD, PhD
Akira Joraku, MD, PhD
Toshihiro Saito, MD, PhD
Takuma Kato, MD, PhD
Manabu Kato, MD, PhD
Hideki Enokida, MD, PhD
Shinichi Sakamoto, MD, PhD
Naoki Terada, MD, PhD
Hidenori Kanno, MD, PhD
Naotaka Nishiyama, MD, PhD
Takahiro Kimura, MD, PhD
Hiroshi Kitamura, MD, PhD
Masatoshi Eto, MD, PhD
the Japanese Urological Oncology Group
Publication date
14-02-2024
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 6/2024
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-024-14999-2

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