Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/11465
Title: Algorithm for selecting men for pelvic lymph node dissection (PLND) during radical prostatectomy based on clinical risk factors in an Australian population.
Authors: Sengupta, Shomik;Weerakoon, Mahesha;Sethi, Kapil;Ischia, Joseph J;Webb, David R
Affiliation: Department of Urology, Austin Health, Heidelberg, Victoria, Australia. senguptaurology@gmail.com
Issue Date: 1-Apr-2012
Citation: Bju International; 109 Suppl 3(): 48-51
Abstract: To define selection criteria for pelvic lymph node dissection (PLND) based on a contemporary Australian cohort of men with clinically localised prostate cancer undergoing radical prostatectomy (RP) with PLND, as stage migration of prostate cancer has led to re-evaluation of the role of PLND at the time of RP.In all, 200 consecutive men treated by one surgeon between 2000 and 2005 with open RP and PLND. The clinical and pathological data were extracted by retrospective chart review. Associations between clinical predictors and LN positivity were assessed by logistic regression analysis.Overall, there were LN metastases were in 10 (5%) men. The LN positivity rate was significantly associated with biopsy Gleason score, preoperative prostate-specific antigen (PSA) concentration and percentage of positive cores (PPC), with respective odds ratios (OR) (95% confidence interval [CI]) of 3.70 (1.98-6.92), 1.11 (1.04-1.19) and 1.04 (1.01-1.06) Trend toward significant association with clinical stage (OR 1.75, 95% CI 0.97-3.13) On multivariate analysis, PSA concentration and biopsy Gleason score were significant predictors of LN disease. All 10 men with LN metastases came from a high-risk group of 96, identifiable by having at least one of the following: stage ≥ cT2b, biopsy Gleason score ≥ 4+3, PSA concentration of ≥ 10 ng/mL or PPC of ≥ 38%.The risk of LN metastases depends upon well-defined clinical risk factors of stage, biopsy Gleason score, PSA concentration and PPC. The present data suggests a simple risk-stratification method, using these risk factors, of identifying men to have PLND at the time of RP.
Internal ID Number: 22458494
URI: http://ahro.austin.org.au/austinjspui/handle/1/11465
DOI: 10.1111/j.1464-410X.2012.11047.x
URL: http://www.ncbi.nlm.nih.gov/pubmed/22458494
Type: Journal Article
Subjects: Aged
Aged, 80 and over
Algorithms
Biopsy
Follow-Up Studies
Humans
Incidence
Lymph Node Excision.methods
Lymph Nodes.pathology.surgery
Lymphatic Metastasis
Male
Middle Aged
Neoplasm Staging
Patient Selection
Pelvis
Prognosis
Prostatectomy.methods
Prostatic Neoplasms.epidemiology.secondary.surgery
Retrospective Studies
Risk Assessment.methods
Risk Factors
Victoria.epidemiology
Appears in Collections:Journal articles

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