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. 2022 Jul 1;23(7):2279-2284.
doi: 10.31557/APJCP.2022.23.7.2279.

Adjuvant Treatment Approaches after Radical Prostatectomy with Lymph Node Involvement

Hasan Hüseyin Tavukçu  1 , Oğuzcan Erbatu  2 , Bülent Akdoğan  3 , Volkan İzol  4 , Uğur Yücetaş  5 , Sinan Sözen  6 , Güven Aslan  7 , Bahadır Şahin  8 , İlker Tinay  9 , Talha Müezzinoğlu  2 , Sumer Baltacı  10
Affiliations

Adjuvant Treatment Approaches after Radical Prostatectomy with Lymph Node Involvement

Hasan Hüseyin Tavukçu et al. Asian Pac J Cancer Prev. .

Abstract

Objective: The aim of this study was to evaluate the adjuvant treatment preferences and effects on disease progression in patients with pathologically positive lymph node prostate cancer.

Methods: Patients who underwent radical prostatectomy from the prostate cancer database of the Turkish Urooncology Association with lymph node involvement were included in the study. Database includes prostate cancer patients from many experience Urooncology centers of Turkey. Adjuvant treatment approaches and the factors that effect the PSA recurrrence was analysed.

Results: Postoperative median 2 (1-3) lymph nodes were found to be positive, and the median lymph node density was reported as 0.13 (0.07-0.25). Seventy-four percent of patients received adjuvant treatment postoperatively. Seventy four of the patients (46.54%) received hormonal therapy in combination with radiotherapy; 47 of them (29.55%) received only hormonal treatment and 20(12.57%) only received radiotherapy. The number of lymph nodes removed was less in the group requiring adjuvant treatment, and this group had a higher rate of surgical margin positivity and seminal vesicle invasion. In addition, adjuvant treatment group had a statistically significant higher lymph node density. There was no significant difference in Kaplan-Meier method comparing 5-year PSA recurrence-free survival in patients with and without adjuvant therapy. When the patient clustered as non-adjuvant, only hormonal therapy and hormonal therapy with radiotherapy, a significant survival advantage was found in the hormonal therapy with radiotherapy group compared to the other two groups (p=0.043).

Conclusion: No significant difference was found between two groups in terms of time until PSA recurrence during our follow-up. In subgroup analysis survival advantage was found in the hormonal therapy with radiotherapy group compared to non-adjuvant and only hormonal therapy groups.

Keywords: Pelvic lymph node dissection; Prostate Cancer; adjuvant; lymph node metastases; radical prostatectomy.

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Conflict of interest statement

Authors declared no conflict of interest.

Figures

Figure 1
Figure 1
Kaplan-Meier Method Comparing 5-year PSA recurrence-free Survival in Patients with and without Adjuvant Therapy
Figure 2
Figure 2
Kaplan-Meier Method Comparing 5-Year PSA Recurrence-Free Survival in Patients Non-Adjuvant, only Hormonal Therapy and Hormonal Therapy with Radiotherapy
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