Dm. Hoenig et al., RISK OF NODAL METASTASES AT LAPAROSCOPIC PELVIC LYMPHADENECTOMY USINGPSA, GLEASON SCORE, AND CLINICAL STAGE IN MEN WITH LOCALIZED PROSTATE-CANCER, Journal of endourology, 11(4), 1997, pp. 263-265
Laparoscopic pelvic lymph node dissection (LPLND) is a low-morbidity p
rocedure used to stage prostate cancer accurately prior to definitive
local therapy, To better select patients for LPLND, we reviewed the cl
inical features of 120 patients with clinically localized prostate can
cer who underwent LPLND to define significant risk factors for nodal m
etastases, The age ranged from 43 to 79 years (mean 68), Serum prostat
e specific antigen (PSA) concentration ranged from 1.3 to 329 ng/mL, G
leason score ranged from 2 to 9, and clinical stage ranged from T1b to
T3c, Nodal metastases were discovered in 15 patients (13%), Among men
with a Gleason score greater than or equal to 7, 21% had nodal metast
ases (P = 0.004), A serum PSA >20 ng/mL and clinical stage T1b, T2b, o
r greater also were statistically significant predictors of lymph node
metastases (20% and 19%, respectively), In multivariate analysis, Gle
ason score: significantly predicted nodal metastases when controlling
for all other clinical measures, Therefore, LPLND is indicated for arm
y patient with a Gleason score greater than or equal to 7, PSA >20 ng/
mL, and advanced clinical T stage, independently or in combination.