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Pelvic lymph node dissection and its extent on survival benefit in prostate cancer patients with a risk of lymph node invasion>5%: a propensity score matching analysis from SEER database

Date

30 Sep 2019

Session

Poster Display session 3

Presenters

Junru Chen

Citation

Annals of Oncology (2019) 30 (suppl_5): v325-v355. 10.1093/annonc/mdz248

Authors

J. Chen1, Z. Wang1, J. Zhao1, S. Zhu1, G. Sun1, J. Liu1, H. Zhang1, X. Zhang1, P. Shen2, H. Zeng1

Author affiliations

  • 1 Urology, West China Hospital, Sichuan University, 610041 - Chengdu/CN
  • 2 Urology, West China Hospital, 610041 - Chengdu/CN
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Background

The aim of the study was to evaluate the therapeutic role of pelvic lymph node dissection (PLND) and its extent in North American patients with a risk of lymph node invasion (LNI)>5%.

Methods

Data of 20,668 patients treated with radical prostatectomy (RP) with and without PLND from SEER database between 2010 and 2015 were retrospectively analyzed. All patients had a risk of LNI>5% according to 2012-Briganti nomogram. Propensity score matching (PSM) was performed to balance baseline characteristics between patients with and without PLND. Kaplan-Meier curves and Cox regression were used to evaluate the impacts of the PLND and its extent on cancer-specific survival (CSS) and overall survival (OS).

Results

The median follow-up was 32 months. In overall cohort, patients with PLND were associated with more aggressive clinicopathologic characteristics and had poorer survival compared to those without PLND (5-year CSS rate: 98.4% vs. 99.7%, p < 0.001; 5-year OS rate: 96.3% vs. 97.8%, p < 0.001). PSM resulted in 4,267 patients in each group. In the post-PSM cohort, no significant difference in survival was found between patients with and without PLND (5-year CSS rate: 99.4% vs. 99.7%, p = 0.479; 5-year OS rate: 97.3% vs. 97.8%, p = 0.204). In addition, the extent of PLND had no impact on prognosis (all p < 0.05). Subgroup analyses reported similar negative findings.

Conclusions

Neither PLND nor its extent was associated with survival in North American patients with a risk of LNI>5%.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Hao Zeng.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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