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SHR Neuro Cancer Cardio Lipid Metab Microb

Kluth, LA; Abdollah, F; Xylinas, E; Rieken, M; Fajkovic, H; Seitz, C; Sun, M; Karakiewicz, PI; Schramek, P; Herman, MP; Becker, A; Hansen, J; Ehdaie, B; Loidl, W; Pummer, K; Lee, RK; Lotan, Y; Scherr, DS; Seiler, D; Ahyai, SA; Chun, FK; Graefen, M; Tewari, A; Nonis, A; Bachmann, A; Montorsi, F; Gönen, M; Briganti, A; Shariat, SF.
Clinical nodal staging scores for prostate cancer: a proposal for preoperative risk assessment.
Br J Cancer. 2014; 111(2):213-9 Doi: 10.1038/bjc.2014.311 [OPEN ACCESS]
Web of Science PubMed PUBMED Central FullText FullText_MUG

 

Co-authors Med Uni Graz
Ahyai Sascha
Pummer Karl
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Abstract:
BACKGROUND: Pelvic lymph node dissection in patients undergoing radical prostatectomy for clinically localised prostate cancer is not without morbidity and its therapeutical benefit is still a matter of debate. The objective of this study was to develop a model that allows preoperative determination of the minimum number of lymph nodes needed to be removed at radical prostatectomy to ensure true nodal status. METHODS: We analysed data from 4770 patients treated with radical prostatectomy and pelvic lymph node dissection between 2000 and 2011 from eight academic centres. For external validation of our model, we used data from a cohort of 3595 patients who underwent an anatomically defined extended pelvic lymph node dissection. We estimated the sensitivity of pathological nodal staging using a beta-binomial model and developed a novel clinical (preoperative) nodal staging score (cNSS), which represents the probability that a patient has lymph node metastasis as a function of the number of examined nodes. RESULTS: In the development and validation cohorts, the probability of missing a positive lymph node decreases with increase in the number of nodes examined. A 90% cNSS can be achieved in the development and validation cohorts by examining 1-6 nodes in cT1 and 6-8 nodes in cT2 tumours. With 11 nodes examined, patients in the development and validation cohorts achieved a cNSS of 90% and 80% with cT3 tumours, respectively. CONCLUSIONS: Pelvic lymph node dissection is the only reliable technique to ensure accurate nodal staging in patients treated with radical prostatectomy for clinically localised prostate cancer. The minimum number of examined lymph nodes needed for accurate nodal staging may be predictable, being strongly dependent on prostate cancer characteristics at diagnosis.
Find related publications in this database (using NLM MeSH Indexing)
Aged - administration & dosage
Aged, 80 and over - administration & dosage
Cohort Studies - administration & dosage
Humans - administration & dosage
Lymph Node Excision - administration & dosage
Lymphatic Metastasis - administration & dosage
Male - administration & dosage
Middle Aged - administration & dosage
Neoplasm Staging - administration & dosage
Prostatectomy - administration & dosage
Prostatic Neoplasms - pathology, surgery
Risk Assessment - administration & dosage

Find related publications in this database (Keywords)
prostate cancer
pelvic lymph node dissection
lymph node metastasis
extended lymph node dissection
nodal yield
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