[Prostate cancer patients with lymph node metastasis. Outcome in a consecutive group of 59 patients]

Abstract

Introduction: The optimal management of prostate cancer patients with lymph node metastasis remains controversial. In this article, the outcome in a consecutive group of patients with newly diagnosed lymph node positive prostate cancer is presented.

Materials and methods: In 59 patients with histological verified lymph node positive disease but without osseous metastasis, outcome is described by time to biochemical progression, time to metastasis and survival.

Results: Median age at diagnosis was 62 years. Median pre-treatment PSA was 21 ng/ml. Endocrine treatment was initiated within median 2 weeks in 97% of the patients. Median follow-up was 3 years. Median time to biochemical progression was 1.8 years and 5-year biochemical recurrence-free survival was 14%. Median time to development of osseous metastasis was 4.4 years and 5-year metastasis-free survival was 49%. Eighteen of the 59 patients died during follow-up, 15 deaths were attributable to prostate cancer. Estimated median survival was 5.5 years.

Conclusion: Despite early androgen deprivation therapy, patients with lymph node positive prostate cancer have a grave prognosis with a high risk of progression and disease-specific mortality.