In:
BJU International, Wiley, Vol. 119, No. 3 ( 2017-03), p. 444-448
Abstract:
To assess factors associated with lymphatic drainage and lymph node ( LN ) metastasis to the prostatic anterior fat pad ( PAFP ) in men with prostate cancer and the utility of routine PAFP analysis at the time of radical prostatectomy ( RP ). Patients and Methods Our institution began to prospectively collect PAFP tissue in 2010. The PAFP was removed at the time of RP and sent as a pathological specimen separate from the pelvic LN s and prostate. Consecutive RP s performed at our institution in which the PAFP was removed were reviewed to determine the rate of LN s in the PAFP , the rate of metastatic LN s in the PAFP , and the association of metastatic PAFP LN with clinical and pathological features. The impact on biochemical recurrence ( BCR ) was assessed with a Cox's proportional hazard model. Results In all, 2 413 PAFP specimens were available for analysis. LN s were found in the PAFP in 255 (10.6%) cases and metastatic LN s in the PAFP s were found in 14 (0.6%) cases. Metastatic PAFP LN s were associated with anterior tumours in 11 of the 14 cases ( P = 0.01), and were present only in preoperative D'Amico intermediate‐ (six of 14) and high‐ (eight of 14) risk patients ( P 〈 0.001). Metastatic PAFP LN s were associated with extraprostatic disease in 13 of the 14 cases, although concomitant pelvic LN involvement was present in only four of the 14 cases. With a mean follow‐up of 1.5 years, three of the 14 patients with metastatic PAFP LN developed BCR . Positive LN involvement in either the pelvic LN or PAFP had worse BCR than LN ‐negative patients ( P 〈 0.001); however, there was no difference in BCR between patients with positive pelvic LN and positive PAFP LN ( P = 0.5). Conclusion Metastatic PAFP LN s are rare and always occur in the presence of other adverse pathological features. The routine pathological analysis of PAFP as a separate specimen, especially in low‐risk disease, may not be warranted.
Type of Medium:
Online Resource
ISSN:
1464-4096
,
1464-410X
DOI:
10.1111/bju.2017.119.issue-3
Language:
English
Publisher:
Wiley
Publication Date:
2017
detail.hit.zdb_id:
2019983-1
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