Faculty of Medicine, Minia University, Minia, Egypt.
Online Research Club, Nagasaki, Japan.
Urol Int. 2020;104(9-10):699-709. doi: 10.1159/000505410. Epub 2020 Apr 8.
Prostate cancer (PCa) is the third leading cause of death from cancer in the United States. We aimed to disclose the prognostic values of examined (dissected) lymph node (ELN), negative lymph node (NLN), and positive (metastatic) lymph node (PLN) counts and lymph node (LNs) ratio in PCa patients.
We extracted data of PCa patients diagnosed between 2004 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) program. We included patients with a histologically confirmed diagnosis having at least one ELN and with the PCa as the primary tumor only.
We have included 96,064 patients. Multivariable Cox proportional hazards regression modelsdisclosed that patients having more ELNs were associated with better survival. However, we demonstrated that patients having more PLNs were associated with worse survival. Additionally, older age, unmarried patients, with Gleason's score of 8-10, T4 and M1 stages and those who received chemotherapy and/or radiation but did not receive surgery were significantly associated with worse PCa survival.
We have disclosed several independent predictors affecting PCa patients including age, marital status, Gleason's score, T and N stages, having received therapy, surgery, and ELN and PLN counts. Moreover, we demonstrated that patients with lower ELN and higher PLN counts were a high-risk group. We strongly recommend adding the ELN and/or PLN counts into consideration during patient staging/treatment.
前列腺癌（PCa）是美国癌症死亡的第三大原因。我们旨在揭示检查（解剖）淋巴结（ELN）、阴性淋巴结（NLN）、阳性（转移性）淋巴结（PLN）计数和淋巴结（LNs）比值对 PCa 患者的预后价值。
我们从监测、流行病学和最终结果（SEER）计划中提取了 2004 年至 2015 年间诊断为 PCa 的患者数据。我们纳入了至少有一个 ELN 且仅以 PCa 为原发性肿瘤的患者。
我们纳入了 96064 名患者。多变量 Cox 比例风险回归模型显示，具有更多 ELN 的患者具有更好的生存。然而，我们表明，具有更多 PLN 的患者与更差的生存相关。此外，年龄较大、未婚、Gleason 评分 8-10、T4 和 M1 期以及接受化疗和/或放疗但未接受手术的患者与 PCa 生存较差显著相关。
我们已经揭示了几个影响 PCa 患者的独立预测因素，包括年龄、婚姻状况、Gleason 评分、T 和 N 分期、接受治疗、手术以及 ELN 和 PLN 计数。此外，我们表明，ELN 和/或 PLN 计数较低的患者属于高危人群。我们强烈建议在患者分期/治疗期间考虑增加 ELN 和/或 PLN 计数。
