title: Comparison of biochemical recurrence-free survival between periprostatic and pelvic lymph node metastases of prostate cancer.
abstract: OBJECTIVE
  To assess the pathologic characteristics and prognostic significance of periprostatic lymph node (LN) metastasis of prostate cancer. The latter was performed by comparing biochemical recurrence (BCR)-free survival in cases of periprostatic LN metastasis versus matched patients showing pelvic LN metastasis.
  
  
  METHODS
  We identified 15 patients who underwent radical prostatectomy in our institution (1984-2011) showing positive periprostatic and negative pelvic LN with available follow-up information (group 1). These patients were matched 1:2 to patients with positive pelvic LN (group 2) for pertinent clinicopathologic parameters.
  
  
  RESULTS
  Main locations of positive periprostatic LN were posterior base and mid posterolateral. Overall higher rate of positive margins, smaller LN, and metastasis size were encountered in group 1 compared with group 2. At 5 years postprostatectomy, 69% of patients in group 1 were free of BCR, whereas 26% of those in group 2 remained BCR free, suggesting that patients with periprostatic node metastasis appeared to have a lower risk of BCR. However, the difference was not statistically significant (P = .072). The same was true when adjusted for the effect of prostate-specific antigen, surgical margin status, size of LNs, size of metastasis, age, and year of surgery.
  
  
  CONCLUSIONS
  Patients with periprostatic node metastasis may have a lower risk of BCR compared with those with metastasis to pelvic LN. Future analysis of larger cohorts will help establish the biologic significance of prostate cancer metastasis to periprostatic LN.
authors.affiliation: Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors.forename: Nilda
authors.initials: N
authors.lastname: González-Roibón
authors.forename: Jeong S
authors.initials: JS
authors.lastname: Han
authors.forename: Stephen
authors.initials: S
authors.lastname: Lee
authors.forename: Zhaoyong
authors.initials: Z
authors.lastname: Feng
authors.forename: Sehbal
authors.initials: S
authors.lastname: Arslankoz
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Smith
authors.forename: Philip M
authors.initials: PM
authors.lastname: Pierorazio
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Humphreys
authors.forename: Theodore L
authors.initials: TL
authors.lastname: Deweese
authors.forename: Alan W
authors.initials: AW
authors.lastname: Partin
authors.forename: Trinity J
authors.initials: TJ
authors.lastname: Bivalacqua
authors.forename: Misop
authors.initials: M
authors.lastname: Han
authors.forename: Bruce
authors.initials: B
authors.lastname: Trock
authors.forename: Georges J
authors.initials: GJ
authors.lastname: Netto
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000556:secondary* / Q000601:surgery; D000368:Aged; D018572:Disease-Free Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000401:mortality; D011471:Prostatic Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery
chemical_list: D017430:Prostate-Specific Antigen
keywords: biochemical recurrence; metastasis; periprostatic lymph node; prostate cancer; prostatectomy
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