The effect of lymph node dissection on oncological outcomes in contemporary robotic salvage radical prostatectomy patients : a junior ERUS/YAU collaborative study
Wenzel, M. (Goethe University Hospital Frankfurt)
Würnschimmel, C. (Luzerner Kantonsspital)
Covas Moschovas, M. (AdventHealth Global Robotics Institute)
Nathan, A. (University College London Hospitals NHS Foundation Trust)
Wagner, Cordula (St. Antonius-Hospital)
Calleris, G. (University of Turin and Città della Salute e della Scienza)
Di Maida, F. (University of Florence)
Rivas, J.G. (Hospital Clínico San Carlos)
Bravi, C.A. (ORSI Academy)
De Groote, R. (ORSI Academy)
Piramide, F. (University of Turin)
Turri, F. (University of Milan)
Kowalczyk, K. (MedStar Georgetown University Hospital)
Sharma, G. (Medanta The Medicity)
Andras, I. (Iuliu Hatieganu University of Medicine and Pharmacy)
Lambert, E. (Ghent University Hospital)
Liakos, N. (Medical Centre of the University of Freiburg)
Darlington, D. (Royal Surrey County Hospital)
Paciotti, M. (Humanitas Research Hospital- IRCCS)
Sorce, G. (IRCCS San Raffaele Hospital)
Mandel, P. (Goethe University Hospital Frankfurt)
Galfano, A. (ASST Grande Ospedale Metropolitano Niguarda Urology Department)
Marra, G. (University of Turin and Città della Salute e della Scienza)
Nathan, S. (University College London Hospitals NHS Foundation Trust)
Dell'Oglio, P. (ASST Grande Ospedale Metropolitano Niguarda Urology Department)
Mottrie, A. (ORSI Academy)
Chun, F.K.H. (Goethe University Hospital Frankfurt)
Patel, V. (AdventHealth Global Robotics Institute)
Breda, Alberto (Institut de Recerca Sant Pau)
Larcher, A. (IRCCS San Raffaele Hospital)
Universitat Autònoma de Barcelona. Departament de Medicina

Fecha:	2025
Resumen:	Purpose: Surgical features associated with better cancer-control outcomes are under investigation for salvage radical prostatectomy patients undergoing robotic approaches. Methods: The Junior ERUS/Young Academic Urologist Working Group in Robotics in Urology conducted a multicentric project to investigate the effect of lymph node dissection (LND) and pN stage on biochemical recurrence-free (BCR), metastases-free (MFS) and overall survival (OS) outcomes in 444 robotic salvage radical prostatectomy (s-RARP) patients. Results: Of all patients, 63% underwent LND with a median of eight removed lymph nodes. Patients without LND more frequently underwent initial focal therapy (60% vs. 37%) and harbored higher pathological Gleason score 8-10 (both p ≤ 0. 02). In BCR analyses, no differences were observed between patients with vs. without LND with 24-months BCR-free survival rates of 74. 8% vs. 73. 6%. In OS analyses, better OS for LND patients (HR: 0,39, p = 0. 049) was observed with 60-months OS rates of 81. 3% vs. 92. 1% for no LND vs. LND. Of LND patients. 16% harbored pN1 stage, which was associated with worse BCR-free survival (HR: 2. 0,p = 0. 025) with 60-months BCR-free survival rates of 63% for pN0 vs. 49. 6% for pN1. In MFS analyses, no difference between both groups were observed. In OS analyses, the observed differences did not reach statistical significance with 60-months OS rates of 93. 4% for pN0 vs. 84. 7% for pN1. Conclusion: Rates of LND are relatively low in contemporary s-RARP patients and are more frequently performed in patients with worse characteristics. However, LND may be associated with better OS, while pN1 patients are associated with worse cancer-control outcomes.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	BCR ; Brachytherapy ; MFS ; Recurrent prostate cancer ; SRARP
Publicado en:	World journal of urology, Vol. 43 Núm. 1 (december 2025) , p. 288, ISSN 1433-8726

DOI: 10.1007/s00345-025-05586-5
PMID: 40343566

8 p, 1.1 MB

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