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Differences in rates of pelvic lymph node dissection in National Comprehensive Cancer Network favorable,unfavorable intermediate-and high-risk prostate cancer across United States SEER registries

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Current Urology 2022年第4期16卷 191-196页

作者： Rocco Simone Flammia Benedikt Hoeh Francesco Chierigo Lukas Hohenhorst Gabriele Sorce Zhen Tian Costantino Leonardo Markus Graefen carlo terrone Fred Saad Shahrokh F.Shariat Alberto Briganti Francesco Montorsi Felix K.H.Chun Michele Gallucci Pierre I.Karakiewicz Department of Maternal-Child and Urological Sciences Sapienza University RomePoliclinico Umberto I HospitalRome00161Italy Cancer Prognostics and Health Outcomes Unit Division of UrologyUniversity of Montréal Health CenterMontréalQuebecCanada Department of Urology University Hospital FrankfurtFrankfurt am MainGermany IRCCS Ospedale Policlinico San Martino GenovaItaly Martini-Klinik Prostate Cancer Center University Hospital Hamburg-Eppendorf HamburgGermany Department of Urology University Hospital Hamburg-Eppendorf HamburgGermany Department of Urology and Division of Experimental Oncology URIUrological Research InstituteIRCCS San Raffaele Scientific InstituteMilanItaly Department of Urology Comprehensive Cancer CenterMedical University of ViennaViennaAustria Department of Urology Weill Cornell Medical CollegeNew YorkNYUSA Department of Urology University of Texas SouthwesternDallasTXUSA Hourani Center for Applied Scientific Research Al-Ahliyya Amman UniversityAmmanJordan

Background:The National Comprehensive Cancer Network(NCCN)guidelines recommend pelvic lymph node dissection(PLND)in NCCN high-and intermediate-risk prostate cancer *** tested for PLND nonadherence(no-PLND)rates within the Surveillance Epidemiology and End Results(2010-2015).Materials and methods:We identified all radical prostatectomy patients who fulfilled the NCCN PLND guideline criteria(n=23,495).Nonadherence rates to PLND were tabulated and further stratified according to NCCN risk subgroups,race/ethnicity,geographic distribution,and year of ***:Overall,the no-PLND rate was 26%;it was 41%,25%,and 11%in the NCCN intermediate favorable,intermediate unfavorable,and high-risk prostate cancer patients,respectively(p<0.001).Overtime,the no-PLND rates declined in the overall cohort and within each NCCN risk *** exhibited the highest no-PLND rate(49%),whereas New Jersey exhibited the lowest(15%).Finally,no-PLND race/ethnicity differences were recorded only in the NCCN intermediate unfavorable subgroup,where Asians exhibited the lowest no-PLND rate(20%)versus African Americans(27%)versus Whites(26%)versus Hispanic-Latinos(25%).Conclusions:The lowest no-PLND rates were recorded in the NCCN high-risk patients followed by NCCN intermediate unfavorable and favorable risk in that *** findings suggest that unexpectedly elevated differences in no-PLND rates warrant further *** all the NCCN risk subgroups,the no-PLND rates decreased over time.

关键词： Lymph node excision Pelvic lymph node dissection Prostatectomy Prostatic neoplasms

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The association of type and number of high-risk criteria with cancer-specific mortality in prostate cancer patients treated with radical prostatectomy

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Current Urology 2024年第2期18卷 128-132页

作者： Francesco Chierigo Rocco Simone Flammia GabrieleSorce Benedikt Hoeh Lukas Hohenhorst Andrea Panunzio Zhe Tian Fred Saad Marcus Graefen Michele Gallucci Alberto Briganti Francesco Montorsi Felix K.H.Chun Shahrokh F.Shariat Alessandro Antonelli Giovanni Guano Guglielmo Mantica Marco Borghesi Nazareno Suardi carlo terrone Pierre I.Karakiewicz Department of Surgical and Diagnostic Integrated Sciences University of GenovaGenovaItaly IRCCS Ospedale Policlinico San Martino GenovaItaly Cancer Prognostics and Health Outcomes Unit Division of UrologyUniversity ofMontréal Health CenterMontréalQuébecCanada Department of Urology IRCCS Policlinico San MartinoGenovaItaly Department of Maternal-Child and Urological Sciences Sapienza Rome UniversityPoliclinico Umberto I HospitalRomeItaly Department of Urology University Hospital FrankfurtFrankfurt am MainGermany Martini-Klinik Prostate Cancer Center University Hospital Hamburg-EppendorfHamburgGermany Department of Urology University of VeronaAzienda Ospedaliera Universitaria Integrata di VeronaVeronaItaly Division of Experimental Oncology/Unit of Urology URIUrological Research InstituteIRCCS San Raffaele Scientific InstituteMilanItaly Department of Urology Comprehensive Cancer CenterMedical University of ViennaViennaAustria Department of Urology Weill Cornell Medical CollegeNew YorkNYUSA Department of Urology University of Texas SouthwesternDallasTXUSA Department of Urology Second Faculty of MedicineCharles UniversityPragueCzech Republic Institute for Urology and Reproductive Health I.M.Sechenov First Moscow State Medical UniversityMoscowRussia Division of Urology Department of Special SurgeryJordan University HospitalThe University of JordanAmmanJordan

Objectives:This study aimed to test the association between of type and number of D'Amico high-risk criteria(DHRCs)with cancer-specific mortality(CSM)in high-risk prostate cancer patients treated with radical *** and methods:In the Surveillance,Epidemiology,and End Results database(2004–2016),we identified 31,281 radical prostatectomy patients with at least 1 DHRC,namely,prostate-specific antigen(PSA)>20 ng/mL(hrPSA),biopsy Gleason Grade Group(hrGGG)score of 4 and 5,or clinical tumor stage≥T3(hrcT).Multivariable Cox regression models and competing risks regression models(adjusting for other cause mortality)tested the association between DHRCs and 5-year ***:Of 31,281 patients,14,394(67%)exclusively harbored hrGGG,3189(15%)harbored hrPSA,and 1781(8.2%)harbored *** 2132 patients(6.8%)harbored a combination of the 2 DHRCs,and 138(0.6%)had all 3 ***-year CSMrates ranged from 0.9%to 3.0%when any individual DHRC was present(hrcT,hrPSA,and hrGGG,in that order),1.6%to 5.9%when 2 DHRCs were present(hrPSA-hrcT,hrcT-hrGGG,and hrPSA-hrGGG,in that order),and 8.1%when all 3 DHRCs were *** regression models and competing risks regression confirmed the independent predictor status of DHRCs for 5-year CSM that was observed in univariable analyses,with hazard ratios from 1.00 to 2.83 for 1 DHRC,2.35 to 5.88 for combinations of 2 DHRCs,and 7.13 for all 3 ***:Within individual DHRCs,hrcT and hrPSA exhibited weaker effects than hrGGG ***,a dose-response effect was identified according to the number of ***,the type and number of DHRCs allow further risk stratification within the high-risk subgroup.

关键词： High risk prostate cancer Radical prostatectomy Cancer-specific mortality Staging SEER

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