Molecular Lymph Node Status for Prognostic Stratification of Prostate Cancer Patients Undergoing Radical Prostatectomy with Extended Pelvic Lymph Node Dissection

Clinical Cancer Research : an Official Journal of the American Association for Cancer Research
Matthias M HeckRoman Nawroth

Abstract

Purpose: Molecular lymph node (LN) analysis using quantitative polymerase chain reaction (qPCR) detects LN metastases with higher sensitivity than histopathology. However, the prognostic role of molecular LN status in prostate cancer patients treated with radical prostatectomy (RP) and extended pelvic LN dissection (ePLND) is unclear. To investigate the association of molecular compared with histopathologic LN status with biochemical recurrence.Experimental Design: Patients with intermediate and high-risk prostate cancer were prospectively enrolled and underwent RP with ePLND, including the obturator, internal, external, and the common iliac region. LNs ≥3 mm were bisected and examined by standard histopathology and qPCR for Kallikrein3 (KLK3) expression. Biochemical recurrence was defined by confirmed postoperative PSA > 0.2 ng/mL.Results: In 111 patients, 2,411 of 3,173 removed LNs were examined by both methods. Histopathology detected 68 LN metastases in 28 (25%) patients. Molecular analysis confirmed elevated KLK3 expression in 65 histopathologic LN metastases of all 28 pN1 patients (pN1/molN1) and additionally reclassified 224 histopathologic negative LNs and 32 (29%) pN0 patients as LN-positive (pN0/molN1).At a median fol...Continue Reading

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Citations

Mar 7, 2018·Nature Reviews. Urology·Rebecca Kelsey
Jan 25, 2020·The Cancer Journal·Scott Williams
Jan 22, 2020·World Journal of Surgical Oncology·Peng YuanZhiqiang Chen
Sep 27, 2020·Prostate Cancer and Prostatic Diseases·Lukas LungerMatthias M Heck
Sep 4, 2021·Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]·Frank PaulsenArndt-Christian Müller

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