Radical Prostatectomy Outcomes in Patients with Clinical Lymph Node Involvement from The Turkish Urooncology Database

Abstract

Objective: This study aimed to investigate pathological lymph node involvement in selected patients and the relationship of prostate-specific antigen (PSA) progression-free survival rates between patients with and without lymph node involvement on preoperative conventional radiologic imaging. Limited data is available about local treatment outcomes in patients with prostate cancer (PCa) having clinical lymph node involvement. Materials and Methods: Using the national PCa database, patients who underwent radical prostatectomy (RP) and pelvic lymph node dissection between 2001 and 2019, with pathologic lymph node involvement, were included in the study. Patients were divided into two groups as those with and without clinical lymph node involvement by preoperative imaging. Results: A total of 213 patients were included in the final analysis, wherein 164 are with and 49 are without lymph node involvement. After the mean follow-up periods of 33.9 months, a significant difference was not found between the two groups in terms of recurrence, adjuvant treatment necessity, and final status. The multivariate analysis for 5-year PSA recurrence-free survival revealed that surgical margin positivity was the only significant factor (p=0.016, hazard ratio: 2.67, confidence interval: 1.19-5.98). Conclusion: Our results revealed that preoperative clinical lymph node status did not affect the 5-year PSA recurrence-free survival in pathologic lymph node involvement of patients treated with RP and pelvic lymph node dissection. Therefore, RP stands as an effective treatment option in selected patients with PCa having clinical lymph node involvement.