Effect of extend ednode pelvic lymph dissection on postoperative prognosis of middle and high risk prostate cancer patients
Objective To evaluate the impact of extended pelvic lymph node dissection(ePLND)on the prognosis of patients with me-dium to high-risk prostate cancer(PCa)undergoing prostetectomy(RP).Methods A total of 2 472 PCa patients who underwent RP treatment at Puyang People's Hospital(1309 cases)and Anyang People's Hospital(1 163 cases)from May 2010 to December 2020 were recruited.PCa patients were divided into the ePLND group and non ePLND group based on whether they underwent ePLND.Among them,there were 2 283 patients in the ePLND group and 189 patients in the non ePLND group.The postoperative survival status of two groups of patients were com-pared and analyzed.The patients was followed up for(13～107)months,with a median follow-up time of 56(24,72)months.Results ⑴ Five years after surgery:The BCR rate was 60.80%,the distant metastasis rate was 41.22%,the CSS rate was 94.78%,and the overall survival rate was 84.34.⑵ Whether ePLND was performed or not had no effect on the four outcome indicators of the 5-year survival rate(P>0.05);(3)COX regression showed that for PCa patients at 5 years after surgery,various outcome indicators were:① Gleason score,tumor clinical stage,preop-erative serum PSA,positive rate of biopsy needle count,and seminal vesicle invasion were risk factors for BCR(P<0.05);② Gleason score,tu-mor pathological staging,tumor clinical staging,positive postoperative margin,and positive number of biopsy needles were risk factors for dis-tant metastasis(P<0.05);③ Age,preoperative serum PSA,Gleason score,tumor pathological staging,tumor clinical staging,positive postopera-tive margin,and positive biopsy needle count were risk factors for tumor specific survival of CSS(P<0.05);④ Age,preoperative serum PSA,Gleason score,tumor pathological staging,tumor clinical staging,and positive rate of biopsy needle count were risk factors affecting OS(P<0.05).Conclusion Among medium to high-risk PCa patients undergoing RP,whether ePLND is performed or not has no significant impact on their prognosis.
NETL
NSTL
万方数据
维普
