Omission of lymphadenectomy in low risk prostate cancer.
THE AIM of the present study was to evaluate if lymphadenectomy could be safely spared in low risk prostate cancer (PC) patients.


METHODS
From 5/1998 to 10/2005, 100 patients with low risk prostate cancer who had undergone radical prostatectomy (RP) and did not have positive surgical margins were selected. The series included 34 patients submitted to lymphadenectomy including the iliac and obturatory nodes without documented nodal metastasis.


RESULTS
Fifteen patients experienced a biochemical relapse (BR) at a median follow-up of 1.7 years. The pathological stage and not removing the nodes were both significant predictors of biochemical relapse (p-value=0.008 and 0.018) in univariate analysis. Adjusting for baseline imbalances through the Cox's regression model, a relative risk of BR which was more than five-fold higher in patients who had not been subjected to lymphadenectomy (p-value <0.05) was estimated.


CONCLUSIONS
This observational investigation suggests that lymphadenectomy may not be safely spared in low risk prostate cancer patients.
Naselli
Angelo
A
Urology Unit, Surgical Oncology Department, National Institute for Cancer Research, Genoa, Italy. angelo.naselli@auro.it
Andreatta
Rossana
R
Introini
Carlo
C
Fontana
Vincenzo
V
Puppo
Paolo
P
D000368:Aged; D018572:Disease-Free Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*