TY  - JOUR
A1  - Wenzel, Mike
A1  - Preißer, Felix
A1  - Höh, Robert Benedikt
A1  - Welte, Maria-Noemi
A1  - Humke, Clara Julia
A1  - Wittler, Clarissa
A1  - Würnschimmel, Christoph
A1  - Becker, Andreas
A1  - Karakiewicz, Pierre I.
A1  - Chun, Felix
A1  - Mandel, Philipp
A1  - Kluth, Luis
T1  - Influence of biopsy gleason score on the risk of lymph node invasion in patients with intermediate-risk prostate cancer undergoing radical prostatectomy
T2  - Frontiers in Surgery
N2  - Objective: To analyze the influence of biopsy Gleason score on the risk for lymph node invasion (LNI) during pelvic lymph node dissection (PLND) in patients undergoing radical prostatectomy (RP) for intermediate-risk prostate cancer (PCa).
Materials and Methods: We retrospectively analyzed 684 patients, who underwent RP between 2014 and June 2020 due to PCa. Univariable and multivariable logistic regression, as well as binary regression tree models were used to assess the risk of positive LNI and evaluate the need of PLND in men with intermediate-risk PCa.
Results: Of the 672 eligible patients with RP, 80 (11.9%) men harbored low-risk, 32 (4.8%) intermediate-risk with international society of urologic pathologists grade (ISUP) 1 (IR-ISUP1), 215 (32.0%) intermediate-risk with ISUP 2 (IR-ISUP2), 99 (14.7%) intermediate-risk with ISUP 3 (IR-ISUP3), and 246 (36.6%) high-risk PCa. Proportions of LNI were 0, 3.1, 3.7, 5.1, and 24.0% for low-risk, IR-ISUP1, IR-ISUP 2, IR-ISUP-3, and high-risk PCa, respectively (p < 0.001). In multivariable analyses, after adjustment for patient and surgical characteristics, IR-ISUP1 [hazard ratio (HR) 0.10, p = 0.03], IR-ISUP2 (HR 0.09, p < 0.001), and IR-ISUP3 (HR 0.18, p < 0.001) were independent predictors for lower risk of LNI, compared with men with high-risk PCa disease.
Conclusions: The international society of urologic pathologists grade significantly influence the risk of LNI in patients with intermediate- risk PCa. The risk of LNI only exceeds 5% in men with IR-ISUP3 PCa. In consequence, the need for PLND in selected patients with IR-ISUP 1 or IR-ISUP2 PCa should be critically discussed.
KW  - prostate cancer
KW  - lymph node dissection
KW  - intermediate risk
KW  - Gleason score
KW  - lymph node metastases
KW  - predictor
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/62065
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-620651
SN  - 2296-875X
VL  - 8
IS  - art. 759070
SP  - 1
EP  - 6
PB  - Frontiers Media
CY  - Lausanne
ER  -