title: [Non-metastatic prostate cancer treated with exclusive radiotherapy: prognosis of patients according to lymph node radiologic or surgical assessment method. Multivariate retrospective analysis].
abstract: OBJECTIVE
  To compare retrospectively the outcome of localized prostate cancers treated by curative external radiotherapy in which the negative lymphatic status was either surgically or radiologically assessed.
  
  
  METHODS
  From January 1986 to December 1995, 112 patients with localized prostate cancers were found to have no evidence of lymphatic disease in the pelvis. N0 status was assessed either surgically (61 patients, group pN-) or after a CT scan procedure (51 patients, group cN0). The treatment consisted of conventional external radiotherapy using a four-fields box technique to a total dose of 65 Gy. The pelvis was never irradiated.
  
  
  RESULTS
  The two groups did not statistically differ according to age, PSA level, Gleason score, T stage and hormonal therapy. Actuarial NED survival rates were 80% and 60% at five and ten years respectively. At ten years, the actuarial NED survival rates were 78% and 34% in the pN- and cN0 groups respectively (p = 0.003). The multivariate analysis corroborated the positive impact of lymphatic dissection before radiotherapy on disease free survival of T1-T2 patients, but not for T3 stages.
  
  
  CONCLUSIONS
  This retrospective study suggests the inability of CT scan to accurately evaluate the lymph node status in carcinoma of the prostate. Systematic ilio-obturator nodal dissection is strongly recommended in early stages before curative radiotherapy. Only pN-patients should be included in high dose conformal irradiation trials.
authors.affiliation: Institut Jean-Godinot, département d'Oncologie Radiothérapie, BP 171, Reims, France. tan.nguyen@wanadoo.fr
authors.forename: Tan Dat
authors.initials: TD
authors.lastname: Nguyen
authors.forename: Frédéric
authors.initials: F
authors.lastname: Mallet
authors.forename: Michel
authors.initials: M
authors.lastname: Petit
authors.forename: Philippe
authors.initials: P
authors.lastname: Lemaire
authors.forename: Adéla
authors.initials: A
authors.lastname: Cauchois
authors.forename: Michel
authors.initials: M
authors.lastname: Loirette
authors.forename: Corinne
authors.initials: C
authors.lastname: Merle
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D011859:Radiography; D012189:Retrospective Studies; D015996:Survival Rate
vernacular_title: Cancers de prostate non métastatiques traités par radiothérapie exclusive: devenir des patients selon la méthode d'évaluation ganglionnaire radiologique ou chirurgicale. Une analyse rétrospective multivariée.