title: Effect of Gleason scores of lymph node metastases on prognosis of patients with prostate cancer.
abstract: The long-term mortality risk from prostate cancer increases in lymph node (LN) positive patients. This study was done to assess the effect of lymph node Gleason score (LNGS) on prognosis in patients with LN-positive prostate cancer. Among the 1,415 patients who received pelvic lymph node dissection (PLND), 117 (8.4%) patients had a positive LN. The PGS of the prostate specimens and the LNGS of the positive LNs were assessed by uropathologists. The median age of patients at surgery was 67 years (interquartile range [IQR], 62-71 years) and the median follow-up duration was 44.3 months (IQR, 27.0-78.5 months). Pathologic Gleason scores (PGS) of 6-9 included one (0.9%), 53 (49.5%), 22 (20.6%), and 31 (29.0%) patients. The median total number of retrieved LNs was 9.0 (IQR, 5.3-12.8). The median number of positive LNs was one (IQR, 1-2). Cancer architecture with a Gleason pattern and score were observed in LNs as in ordinary prostate specimens. LNGS 6-9 included nine (8.1%), 57 (51.4%), 31 (27.9%), and 14 (12.6%) patients. The speaman's analysis showed the meaningful correlation between PGS and LNGS (P = 0.249, P = 0.011). The univariate analysis showed that the number of positive LNs and LNGS were significantly associated with prostate cancer-specific survival (P = 0.028; P = 0.005). The same architecture that is seen in the prostate was seen in positive LNs, and LNGS may be a significant prognostic factor in patients with LN-positive prostate cancer.
authors.affiliation: Department of Urology, Kandong Sacred Heart Hospital, Hallym University College of Medicine Seoul, Korea.
authors.forename: Kyungtae
authors.initials: K
authors.lastname: Ko
authors.affiliation: Department of Urology, Asan Medical Center, Ulsan University College of Medicine Seoul, Korea.
authors.forename: In Gab
authors.initials: IG
authors.lastname: Jeong
authors.affiliation: Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine Seoul, Korea.
authors.forename: Woo Suk
authors.initials: WS
authors.lastname: Choi
authors.affiliation: Department of Urology, Asan Medical Center, Ulsan University College of Medicine Seoul, Korea.
authors.forename: Ju Hyun
authors.initials: JH
authors.lastname: Lim
authors.affiliation: Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine Seoul, Korea.
authors.forename: Ja Hee
authors.initials: JH
authors.lastname: Suh
authors.affiliation: Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine Seoul, Korea.
authors.forename: Ja Hyeon
authors.initials: JH
authors.lastname: Ku
authors.affiliation: Department of Pathology, Asan Medical Center, Ulsan University College of Medicine Seoul, Korea.
authors.forename: Yangsoon
authors.initials: Y
authors.lastname: Park
authors.affiliation: Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine Seoul, Korea.
authors.forename: Kyung Cheol
authors.initials: KC
authors.lastname: Moon
authors.affiliation: Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine Seoul, Korea.
authors.forename: Hyeon Hoe
authors.initials: HH
authors.lastname: Kim
authors.affiliation: Department of Urology, Asan Medical Center, Ulsan University College of Medicine Seoul, Korea.
authors.forename: Choung-Soo
authors.initials: CS
authors.lastname: Kim
authors.affiliation: Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine Seoul, Korea.
authors.forename: Cheol
authors.initials: C
authors.lastname: Kwak
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D000368:Aged; D001706:Biopsy; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011237:Predictive Value of Tests; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Gleason score; lymph node metastasis; prognosis; prostate cancer; radical prostatectomy