title: [N1 prostatic adenocarcinoma treated with radical surgery and immediate hormonal management].
abstract: OBJECTIVE
  To study the survival in patients with prostate adenocarcinoma, lymph nodes involvement in the intraoperative pathological examination, evaluating both radical surgery and early ablation as treatment. Identification of clinical factors that can predict node involvement.
  
  
  METHODS
  20 patients who underwent radical prostatectomy between 1988-1998 were included in the study. All patients clinically diagnosed with T1-2N0Mx prostate adenocarcinoma (T.N.M. 1992), single metastatic node involvement in the pathological study and early sub-albuginea orchidectomy. This group was compared to a 200-patient control group also with T1-2N0Mx prostate adenocarcinoma but with no pathologic nodular involvement. Statistical study: contingency 2Xb tables (Pearson's chi 2 or Fisher's exact test) to compare qualitative variables; Student's t test for means comparison; Kaplan-Meier for actuarial survival calculations and comparison of Log-rank survival curves. For the study of clinical variants with influence in node involvement a logistic regression model was used.
  
  
  RESULTS
  Mean age was 63 +/- 0.8 years. Median follow up 56 months. Mean PSA 33 +/- 4.4 ng/mL and 55% had Gleason 5-7. 16 patients were stage pT3. Specific 5-year survival was 90 +/- 8% and biochemical progression free survival 63 +/- 12%. Clinical variables with statistical significance for node involvement are: pre-surgical PSA greater than 20 ng/mL (RR = 4.6), and Gleason higher than 4 (RR = 3). The remaining variables showed no statistical significance.
  
  
  CONCLUSIONS
  Gleason and PSA are the only clinical values that predict node involvement. The procedure performed obtains good results and a survival comparable to that of the control group.
authors.affiliation: Departamento de Urología, Universidad de Navarra.
authors.forename: J
authors.initials: J
authors.lastname: Arocena García-Tapia
authors.forename: J J
authors.initials: JJ
authors.lastname: Zudaire Bergera
authors.forename: J
authors.initials: J
authors.lastname: López Ferrandis
authors.forename: D
authors.initials: D
authors.lastname: Sánchez Zalabardo
authors.forename: G
authors.initials: G
authors.lastname: Sanz Pérez
authors.forename: F
authors.initials: F
authors.lastname: Diez-Caballero Alonso
authors.forename: D
authors.initials: D
authors.lastname: Rosell Costa
authors.forename: J E
authors.initials: JE
authors.lastname: Robles García
authors.forename: J M
authors.initials: JM
authors.lastname: Berián Polo
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009919:Orchiectomy; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*