%0 Journal Article
%A Laine, Charles
%A Gandaglia, Giorgio
%A Valerio, Massimo
%A Heidegger, Isabel
%A Tsaur, Igor
%A Olivier, Jonathan
%A Ceci, Francesco
%A van den Bergh, Roderick C N
%A Kretschmer, Alexander
%A Thibault, Constance
%A Chiu, Peter K
%A Tilki, Derya
%A Kasivisvanathan, Veeru
%A Preisser, Felix
%A Zattoni, Fabio
%A Fankhauser, Christian
%A Kesch, Claudia
%A Puche-Sanz, Ignacio
%A Moschini, Marco
%A Pradere, Benjamin
%A Ploussard, Guillaume
%A Marra, Giancarlo
%A EAU-YAU Prostate Cancer Working Party
%T Features and management of men with pN1 cM0 prostate cancer after radical prostatectomy and lymphadenectomy: a systematic review of population-based evidence.
%D 2022
%U http://hdl.handle.net/10668/19857
%X To investigate the features and optimal management of pN+ cM0 prostate cancer (PCa) according to registry-based studies. Up to 15% of PCa patients harbor lymph node invasion (pN+) at radical prostatectomy plus lymph node dissection. Nonetheless, the optimal management strategy in this setting is not well characterized. We performed a systematic review including n = 13 studies. Management strategies comprised 13 536 men undergoing observation, 11 149 adjuvant androgen deprivation therapy (aADT), 7,075 adjuvant radiotherapy (aRT) +aADT and 705 aRT. Baseline features showed aggressive PCa in the majority of men. At a median follow-up ranging 48-134months, Cancer-related death was 5% and overall-mortality 16.6%. aADT and aRT alone had no cancer-specific survival or overall survival advantages over observation only and over not performing aRT, respectively. aADT plus aRT yielded a survival benefit compared to observation and aADT, which in one study, were limited to certain intermediate-risk categories. Age, Gleason, Charlson score, positive surgical margins, pathological stage, and positive nodes number, but not prostate specific antigen, were most relevant prognostic factors. Our work further confirmed pN+ PCa is a multifaceted disease and will help future research in defining its optimal management based on different risk categories to maximize survival and patient's quality of life.
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