30 year follow up on node positive cancer

This study performed a 30-year analysis on the outcome of patients diagnosed with node-positive prostate cancer (N1PC) and treated by radical prostatectomy.

Radical prostatectomy is the surgical removal of the prostate gland, and is a common treatment for prostate cancer. During surgery, the surrounding lymph nodes are also removed and checked for the presence of cancer cells. Cancer that has spread to the surrounding lymph nodes is often referred to as node positive cancer. Generally, the spread of cancer into surrounding lymph nodes is considered a poor prognostic factor and is known to increase the risk of recurrence after treatment. However, no study to date has presented data on the prognosis of N1PC patients involving such an extensive follow-up period.

This study involved a total of 505 patients diagnosed with N1PC and treated with radical prostatectomy.  Among patients with a unilateral tumor (cancer on one side of the prostate) approximately 30% showed contralateral cancer-positive lymph nodes (positive nodes on the opposite side of the tumor). Among patients with a tumor spread across both sides of the prostate, 15% showed bilateral cancer-positive lymph nodes (positive nodes on both sides of the prostate). This data supports the importance of removing bilateral pelvic lymph nodes (from both sides of the prostate gland) during surgery.

15 years following treatment, recurrence free survival of N1PC patients was 41.5%. 15-year cancer specific survival was 57.5%. A high Gleason score and a large number of positive lymph nodes were associated with worse survival.

This study concluded that radical prostatectomy and bilateral lymph node removal offer good long-term cancer-specific survival among patients diagnosed with node-positive prostate cancer.

This analysis did not report the effect of additional therapies received by patients, such as radiation or hormonal therapies.