KEY TAKEAWAYS
- The study aimed to investigate if preoperative inflammation markers and biopsy data improve the prediction of pelvic LN metastasis in patients with PCa.
- Researchers noticed that LVI, bilateral lobe tumors, and lymphocyte count predict pelvic LN metastasis.
Despite advancements in medical technology, predicting pelvic lymph node (LN) metastasis in prostate cancer (PCa) remains challenging. Various nomograms have been used to improve prediction accuracy, yet gaps still exist.
Abdullah Gul and the team aimed to whether preoperative inflammation markers and transrectal prostate biopsy data provide additional insights for predicting pathological LN involvement in patients undergoing radical prostatectomy with extended pelvic LN dissection (RP + ePLND).
They performed an inclusive analysis of patients with PCa who had a Briganti score of 5 or higher and underwent radical prostatectomy with extended pelvic LN dissection between January 2016 and May 2023. Physical examination findings, blood work within 1 month before biopsy, and prostate biopsy results were recorded retrospectively.
Patients were divided into 2 groups based on the presence or absence of pelvic LN metastasis (Group 1 and Group 2, respectively). The preoperative data of both groups were compared for analysis.
About 71 patients participated in the study, with 17 in Group 1 and 54 in Group 2. Significant differences were observed between the groups in terms of bilateral tumour involvement in the prostate, the presence of perineural and lymphovascular invasion (LVI) in biopsy specimens, D’Amico risk group, and various haematological and biochemical parameters, including absolute lymphocyte and monocyte counts, neutrophil-to-lymphocyte ratio, and levels of total and free prostate-specific antigen.
Logistic regression analysis identified absolute lymphocyte count, presence of LVI, and bilateral tumour involvement as independent predictors of pathological pelvic LN metastasis in PCa. The cut-off value for lymphocyte count predicting LN metastasis was 1.57 (103/mL), with a sensitivity of 0.870 and a specificity of 0.412 (area under the curve [AUC]: 0.675, P = 0.030).
The study concluded that LVI in biopsy specimens, bilateral lobe tumors, and preoperative lymphocyte count are significant predictors of pelvic LN metastasis in patients with PCa and a Briganti score of ≥5.
No funding information was given.
Source: https://pubmed.ncbi.nlm.nih.gov/39104228/
Gul A, Ekici O, (2024). “Additional Parameters to the Briganti Nomogram for Predicting Pelvic Lymph Node Metastasis in Prostate Cancer.” Arch Esp Urol. 2024 Jul;77(6):614-621. doi: 10.56434/j.arch.esp.urol.20247706.84. PMID: 39104228.
