RT Journal Article
T1 Features and management of men with pN1 cM0 prostate cancer after radical prostatectomy and lymphadenectomy: a systematic review of population-based evidence.
A1 Laine, Charles
A1 Gandaglia, Giorgio
A1 Valerio, Massimo
A1 Heidegger, Isabel
A1 Tsaur, Igor
A1 Olivier, Jonathan
A1 Ceci, Francesco
A1 van den Bergh, Roderick C N
A1 Kretschmer, Alexander
A1 Thibault, Constance
A1 Chiu, Peter K
A1 Tilki, Derya
A1 Kasivisvanathan, Veeru
A1 Preisser, Felix
A1 Zattoni, Fabio
A1 Fankhauser, Christian
A1 Kesch, Claudia
A1 Puche-Sanz, Ignacio
A1 Moschini, Marco
A1 Pradere, Benjamin
A1 Ploussard, Guillaume
A1 Marra, Giancarlo
A1 EAU-YAU Prostate Cancer Working Party, 
AB 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.
YR 2022
FD 2022
LK http://hdl.handle.net/10668/19857
UL http://hdl.handle.net/10668/19857
LA en
DS RISalud
RD Apr 19, 2025