Department of Urology, University of Health Sciences, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.
Department of Urology, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey.
Asian Pac J Cancer Prev. 2022 Jul 1;23(7):2279-2284. doi: 10.31557/APJCP.2022.23.7.2279.
The aim of this study was to evaluate the adjuvant treatment preferences and effects on disease progression in patients with pathologically positive lymph node prostate cancer.
Patients who underwent radical prostatectomy from the prostate cancer database of the Turkish Urooncology Association with lymph node involvement were included in the study. Database includes prostate cancer patients from many experience Urooncology centers of Turkey. Adjuvant treatment approaches and the factors that effect the PSA recurrrence was analysed.
Postoperative median 2 (1-3) lymph nodes were found to be positive, and the median lymph node density was reported as 0.13 (0.07-0.25). Seventy-four percent of patients received adjuvant treatment postoperatively. Seventy four of the patients (46.54%) received hormonal therapy in combination with radiotherapy; 47 of them (29.55%) received only hormonal treatment and 20(12.57%) only received radiotherapy. The number of lymph nodes removed was less in the group requiring adjuvant treatment, and this group had a higher rate of surgical margin positivity and seminal vesicle invasion. In addition, adjuvant treatment group had a statistically significant higher lymph node density. There was no significant difference in Kaplan-Meier method comparing 5-year PSA recurrence-free survival in patients with and without adjuvant therapy. When the patient clustered as non-adjuvant, only hormonal therapy and hormonal therapy with radiotherapy, a significant survival advantage was found in the hormonal therapy with radiotherapy group compared to the other two groups (p=0.043).
No significant difference was found between two groups in terms of time until PSA recurrence during our follow-up. In subgroup analysis survival advantage was found in the hormonal therapy with radiotherapy group compared to non-adjuvant and only hormonal therapy groups.
本研究旨在评估伴有淋巴结阳性前列腺癌患者的辅助治疗偏好和疾病进展的影响。
本研究纳入了土耳其泌尿科协会前列腺癌数据库中接受根治性前列腺切除术且淋巴结受累的患者。该数据库包括来自土耳其多家经验丰富的泌尿科中心的前列腺癌患者。分析了辅助治疗方法以及影响 PSA 复发的因素。
术后中位 2（1-3）个淋巴结呈阳性，中位淋巴结密度为 0.13（0.07-0.25）。74%的患者术后接受了辅助治疗。74 例患者（46.54%）接受了激素联合放疗；47 例（29.55%）仅接受激素治疗，20 例（12.57%）仅接受放疗。需要辅助治疗的患者淋巴结切除数目较少，且该组的手术切缘阳性和精囊侵犯率较高。此外，辅助治疗组的淋巴结密度显著较高。Kaplan-Meier 法比较了有和无辅助治疗的患者 5 年 PSA 无复发生存率，差异无统计学意义。当患者聚类为非辅助治疗、仅激素治疗和激素联合放疗时，与其他两组相比，激素联合放疗组的生存优势显著（p=0.043）。
在我们的随访期间，两组在 PSA 复发时间方面没有显著差异。在亚组分析中，与非辅助治疗和仅激素治疗组相比，激素联合放疗组的生存优势显著。
