title: Clinical Factors Predicting and Stratifying the Risk of Lymph Node Invasion in Localized Prostate Cancer.
abstract: OBJECTIVE
  The study aimed to investigate clinical factors associating with occult lymph node micrometastases (pN1 disease) in a contemporary cohort of organ-confined prostate cancer (PCA) patients staged as cN0.
  
  
  METHODS
  The study evaluated 184 consecutive patients. Associations of clinical factors with pN1 disease were assessed by multivariate logistic regression analysis.
  
  
  RESULTS
  Lymph node invasion was detected in 33 cases (17.9%). Independent factors associating with pN1 status were prostate specific antigen (PSA; OR 1.054; p = 0.004), percentage of positive biopsy cores (PPC; OR 1.030; p = 0.013), and biopsy Gleason pattern (bGP) >4 + 3 (OR 3.666; p = 0.004). A clinical model predicting the risk of pN1 disease identified 4 prognostic groups of pN1 disease.
  
  
  CONCLUSIONS
  In a contemporary cohort of PCA patients, lymph node invasion was detected in 17.9% of cases. An independent clinical disease showed that the risk of lymph node invasion was directly proportional to PPC and more stratification of the risk of pN1 disease was operated by PSA and BGP. The model allowed the stratification of the patient population in 4 groups and showed that the risk of lymph node invasion progressively increased as the risk group ranked from 1 to 4.
authors.affiliation: Urologic Clinic, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
authors.forename: Antonio Benito
authors.initials: AB
authors.lastname: Porcaro
authors.forename: Nicolò
authors.initials: N
authors.lastname: de Luyk
authors.forename: Paolo
authors.initials: P
authors.lastname: Corsi
authors.forename: Marco
authors.initials: M
authors.lastname: Sebben
authors.forename: Alessandro
authors.initials: A
authors.lastname: Tafuri
authors.forename: Daniele
authors.initials: D
authors.lastname: Mattevi
authors.forename: Tania
authors.initials: T
authors.lastname: Processali
authors.forename: Maria A
authors.initials: MA
authors.lastname: Cerruto
authors.forename: Matteo
authors.initials: M
authors.lastname: Brunelli
authors.forename: Stefano
authors.initials: S
authors.lastname: Zecchini Antoniolli
authors.forename: Salvatore
authors.initials: S
authors.lastname: Siracusano
authors.forename: Walter
authors.initials: W
authors.lastname: Artibani
mesh_terms: D000368:Aged; D001706:Biopsy; D016009:Chi-Square Distribution; D006801:Humans; D007610:Kallikreins / Q000097:blood; D016015:Logistic Models; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D061206:Neoplasm Micrometastasis; D009367:Neoplasm Staging; D016017:Odds Ratio; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen
keywords: Gleason score system; Lymph node; Prostate cancer; Prostate specific antigen; Tumour grade