Differences in the rate of lymph node invasion in men with clinically localized prostate cancer might be related to the continent of origin. Academic Article uri icon

Overview

abstract

  • OBJECTIVE: To test whether the rate of lymph node invasion (LNI) differs between patients treated with radical prostatectomy (RP) at a European or a North American centre. PATIENTS AND METHODS: In all, 1385 men had RP with bilateral lymphadenectomy for clinically localized prostate cancer (587 from Dallas, Texas and 798 from Milan, Italy). Univariate and multivariate analyses focused on the association between the continent of origin and the rate of LNI, after controlling for prostate-specific antigen (PSA) level, clinical stage, biopsy Gleason sum and the number of examined and removed lymph nodes. RESULTS: European men had higher PSA levels (9.1 vs 7.8 ng/mL), a higher proportion of palpable cancers (44.5 vs 32.8%), more nodes removed (mean 14.9 vs 7.8) and a higher rate of LNI (9.0% vs 1.2%; all differences P < 0.001). In multivariate analyses that controlled for PSA level and clinical variables, European men had an 8.9-fold higher risk of LNI (P < 0.001) than their counterparts from the USA. Among preoperative variables, the continent of origin was the third most informative predictor of LNI (67.5%), after biopsy Gleason sum (74.3%) and the number of examined lymph nodes (71.0%), and improved the ability to predict LNI by 4.7%. CONCLUSION: Men treated at a European centre had a 7.3-8.9-fold higher rate of LNI, despite adjusting for all clinical and pathological variables. It remains to be shown what predisposes European men to a higher rate of LNI.

publication date

  • June 15, 2007

Research

keywords

  • Lymph Nodes
  • Prostatic Neoplasms

Identity

Scopus Document Identifier

  • 34547640052

Digital Object Identifier (DOI)

  • 10.1111/j.1464-410X.2007.07005.x

PubMed ID

  • 17573893

Additional Document Info

volume

  • 100

issue

  • 3