AUA 2019: Facility-level Variation in Pelvic Lymph Node Dissection During Radical Prostatectomy and Effect on Overall Survival in Men with Clinically Localized High-risk Prostate Cancer
The authors queried the National Cancer Data Base (NCDB) to identify 13,652 healthy (CCI=0) men aged 18-64 who had undergone RP across 1,023 facilities between 2004-2011 for clinically localized, high-risk PCa (PSA > 20, Gleason score >=8, clinical T stage >=3). Lymph node counts were divided into the following categories:
No/Limited: 0-9 lymph nodes
Standard: 10-16 lymph nodes
Extended: >=17 lymph nodes
Notably, the definitions are based on lymph node number, not anatomical borders. Sensitivity, IPTW-adjusted Cox regression, and subgroup analyses (on patients who underwent adjuvant radiation therapy) were performed.
The authors found significant facility-level variation in the extent of PLND for high-risk, localized PCa across the sites. There was no apparent survival benefit for more extensive lymph node counts, but additional studies, including prospective and randomized studies, are necessary for the future.
Presented by: David Friedlander, MD, Research/Clinical Fellow, Brigham and Women's Hospital
Written by: Selma Masic, MD, Urologic Oncology Fellow (SUO), Fox Chase Cancer Center, @selmasic at the American Urological Association's 2019 Annual Meeting (AUA 2019), May 3 – 6, 2019 in Chicago, Illinois