No difference in biochemical failure rates with or without pelvic lymph node dissection during radical prostatectomy in low-risk patients

Objectives. To detect the short-term differences in biochemical relapse-fre e rates between patients with and without pelvic lymph node dissection (PLN D). Recently, a trend has begun to omit PLND in patients undergoing radical prostatectomy considered at low risk of pelvic lymph node metastases, Methods. The records of 1152 consecutive radical prostatectomy cases were r eviewed. A total of 575 patients with favorable tumor characteristics (pros tate-specific antigen [PSA] 10 ng/mL or less, Gleason score 6 or less, and clinical Stage T1 or T2) who were not receiving adjuvant or neoadjuvant the rapy were divided into two groups according to whether PLND was performed ( PLND group, n = 372) or omitted (no PLND group, n = 203). Proportional haza rds were used to analyze the effect of age, race, family history, stage, bi opsy Gleason score, initial PSA, PLND, and pathologic findings on the likel ihood of biochemical failure. Biochemical failure-free survival for each gr oup was estimated by Kaplan-Meier analysis. The mean follow-up was 38 month s (range 1 to 141). Results. The actuarial 4-year biochemical relapse-free rate for the PLND ve rsus no PLND groups was 91% and 97%, respectively (P = 0.16). On multivaria te analysis, PLND was not an independent predictor of outcome (P = 0.24). Conclusions. The results of our study indicate that the omission of PLND in patients with favorable tumor characteristics does not adversely affect bi ochemical relapse rates. UROLOGY 56: 92-95, 2000, (C) 2000, Elsevier Scienc e Inc.