Department of Urology, Yale School of Medicine, New Haven, CT, 06519, USA.
Curr Oncol Rep. 2023 Jul;25(7):729-734. doi: 10.1007/s11912-023-01420-6. Epub 2023 Apr 18.
Approximately 15% of prostate cancer patients have lymph node metastases at the time of radical prostatectomy (RP). However, there is no universally accepted standard of care for these men. The options for treatment in this subset of patients range from observation to a combination of adjuvant androgen deprivation therapy (aADT) and radiation therapy (RT).
A recent systematic review showed that there was no clear choice out of the options above to treat these patients. Studies have shown that patients treated with adjuvant radiation therapy have lower all-cause mortality when compared to patients treated with salvage radiation therapy. In this review, we summarize treatment options for pathologic node-positive (pN1) patients and discuss the urgent need for robust clinical trials that includes observation as the control group to help establish a standard of care for treating patients with node-positive prostate cancer after RP.
约 15%的前列腺癌患者在根治性前列腺切除术（RP）时存在淋巴结转移。然而，目前尚没有针对这些患者的普遍接受的治疗标准。对于这部分患者的治疗选择范围从观察到辅助雄激素剥夺治疗（aADT）和放射治疗（RT）的联合应用。
最近的一项系统综述表明，上述治疗选择中没有明确的首选方案。研究表明，与接受挽救性放疗的患者相比，接受辅助放疗的患者全因死亡率更低。在这篇综述中，我们总结了病理淋巴结阳性（pN1）患者的治疗选择，并讨论了迫切需要进行强有力的临床试验的必要性，该试验将观察作为对照组，以帮助确定 RP 后治疗淋巴结阳性前列腺癌患者的标准治疗方案。
