Clinical Factors Predicting and Stratifying the Risk of Lymph Node Invasion in Localized Prostate Cancer

Urol Int. 2017;99(2):207-214. doi: 10.1159/000458763. Epub 2017 Mar 1.

Abstract

Purpose: The study aimed to investigate clinical factors associating with occult lymph node micrometastases (pN1 disease) in a contemporary cohort of organ-confined prostate cancer (PCA) patients staged as cN0.

Materials and methods: The study evaluated 184 consecutive patients. Associations of clinical factors with pN1 disease were assessed by multivariate logistic regression analysis.

Results: Lymph node invasion was detected in 33 cases (17.9%). Independent factors associating with pN1 status were prostate specific antigen (PSA; OR 1.054; p = 0.004), percentage of positive biopsy cores (PPC; OR 1.030; p = 0.013), and biopsy Gleason pattern (bGP) >4 + 3 (OR 3.666; p = 0.004). A clinical model predicting the risk of pN1 disease identified 4 prognostic groups of pN1 disease.

Conclusions: In a contemporary cohort of PCA patients, lymph node invasion was detected in 17.9% of cases. An independent clinical disease showed that the risk of lymph node invasion was directly proportional to PPC and more stratification of the risk of pN1 disease was operated by PSA and BGP. The model allowed the stratification of the patient population in 4 groups and showed that the risk of lymph node invasion progressively increased as the risk group ranked from 1 to 4.

Keywords: Gleason score system; Lymph node; Prostate cancer; Prostate specific antigen; Tumour grade.

MeSH terms

  • Aged
  • Biopsy
  • Chi-Square Distribution
  • Humans
  • Kallikreins / blood
  • Logistic Models
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Grading
  • Neoplasm Invasiveness
  • Neoplasm Micrometastasis
  • Neoplasm Staging
  • Odds Ratio
  • Prostate-Specific Antigen / blood
  • Prostatic Neoplasms / blood
  • Prostatic Neoplasms / pathology*
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors

Substances

  • KLK3 protein, human
  • Kallikreins
  • Prostate-Specific Antigen