Devising and external validation of a prognostic classification of metastatic involvement risk to pelvic lymph nodes in patients with newly diagnosed prostate cancer

• Main Authors: E. A. Leusik, P. D. Demeshko, S. A. Krasny
• Format: Article
• Language: Russian
• Published: ABV-press 2015-12-01
• Series: Onkourologiâ
• Subjects: prostate cancer; prognostic classification; metastases; pelvic lymph nodes
• Online Access: https://oncourology.abvpress.ru/oncur/article/view/469
• ISSN: 1726-9776; 1996-1812

Objective – assessing the predictive significance of clinical, histologic and biochemical factors for prediction of metastases in pelvic lymph nodes (MPLN), devising and validating of prognostic classification.Materials and methods. The study enrolled 1140 patients subjected to radical prostatectomy (RPE) with standard pelvic lymphadenectomy for prostate adenocarcinoma: 865 of them at the classification devising stage and 275 in the course of validation.Results. According to the findings of multivariate logistic regression analysis, PSA level, the tumor cT stage and Gleason score are independent predictors of MPLN detection after RPE (p < 0.05). The prognostic factors were stratified by score for assessing the detection of regional metastases after RPE, depending on the combination of predictors. In the group of patients with a score estimate of prognostic factors < 10, the MPLN detection rate was significantly lower than in the group of with a score estimate > 15, accounting for 3.5 % and 23.7 % respectively (р < 0.0001). In the course of validating the obtained findings in clinic, metastatic involvement of pelvic lymph nodes found in the result of RPE was diagnosed in 40.0 % of the patients with a score estimate > 15 and only in 1.3 % of those with a total estimate of prognostic factors < 10 (р < 0.0001).