Impact of Extent of Lymphadenectomy on Survival After Radical Prostatectomy for Prostate Cancer

Overview

Journal Urology

Specialty Urology

Date 2006 Jun 30

PMID 16806432

Citations 67

Authors

Sue A Joslyn

Badrinath R Konety

Affiliations

Soon will be listed here.

Abstract

Objectives: Controversy exists regarding the benefit of extended lymphadenectomy at radical prostatectomy for prostate cancer. We sought to determine whether more extended lymphadenectomy, along with radical prostatectomy, resulted in a decreased risk of prostate cancer-specific death at 10 years.

Methods: Data on all patients undergoing radical prostatectomy (with or without lymphadenectomy) for prostate cancer obtained from the Surveillance, Epidemiology, and End Results Program (1988 to 1991) were examined. All surviving patients had a minimal follow-up of 10 years. Multivariate Cox proportional hazards analysis was used to determine the independent effect of lymphadenectomy on the risk of prostate cancer-specific death.

Results: Patients undergoing excision of at least 4 lymph nodes (node-positive and node-negative patients) or more than 10 nodes (only node-negative patients) had a lower risk of prostate cancer-specific death at 10 years than did those who did not undergo lymphadenectomy. The removal of a greater number of nodes was associated with a greater likelihood of the presence of positive nodes. The presence of more than one positive node was associated with a greater risk of prostate cancer-related death.

Conclusions: Performing more extensive pelvic lymphadenectomy in patients undergoing radical prostatectomy could improve the accuracy of staging and reduce the risk of prostate cancer-specific death in the long term.

Citing Articles

Metastatic lymph nodes outside the extended lymphadenectomy template correlate with advanced staging but not grading in prostate cancer patients undergoing radical prostatectomy.

Karwacki J, Mioskowska A, Tomecka P, Maczka K, Gurwin A, Kobylanski M Int Urol Nephrol. 2025; .

PMID: 40088356 DOI: 10.1007/s11255-025-04450-0.

Extended Lymph Node Dissection May Not Provide a Therapeutic Benefit in Patients with Intermediate-to High-Risk Prostate Cancer Treated with Robotic-Assisted Radical Prostatectomy.

Miura N, Shimbo M, Okawa D, Sakamoto M, Sugihara N, Sawada T Cancers (Basel). 2025; 17(4).

PMID: 40002250 PMC: 11853644. DOI: 10.3390/cancers17040655.

Current status and therapeutic value of extended pelvic lymph node dissection during radical prostatectomy for prostate cancer.

Morizane S, Takenaka A Prostate Int. 2025; 12(3):117-127.

PMID: 39816936 PMC: 11733762. DOI: 10.1016/j.prnil.2024.03.002.

From foes to friends: rethinking the role of lymph nodes in prostate cancer.

Gupta R, Das C, Nair S, Pedraza-Bermeo A, Zahalka A, Kyprianou N Nat Rev Urol. 2024; 21(11):687-700.

PMID: 39095580 DOI: 10.1038/s41585-024-00912-9.

Analysis of the surgical approach in prostate cancer staging: results from the surveillance, epidemiology and end results program.

da Luz F, Nascimento C, da Costa Marinho E, Felicidade P, Antonioli R, de Araujo R Sci Rep. 2023; 13(1):9949.

PMID: 37336940 PMC: 10279689. DOI: 10.1038/s41598-023-37204-y.