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

Alberto Briganti, Shahrokh F. Shariat, Felix K H Chun, Georg C. Hutterer, Claus G. Roehrborn, Andrea Gallina, Patrizio Rigatti, Luc Valiquette, Francesco Montorsi, Pierre I. Karakiewicz

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)528-532
Number of pages5
JournalBJU International
Volume100
Issue number3
DOIs
Publication statusPublished - Sep 2007

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Prostatic Neoplasms
Lymph Nodes
Prostate-Specific Antigen
Prostatectomy
Multivariate Analysis
Biopsy
Lymph Node Excision
Italy
Neoplasms

Keywords

  • Lymph node invasion
  • Pelvic lymphadenectomy
  • Prostate cancer
  • Radical prostatectomy

ASJC Scopus subject areas

  • Urology

Cite this

Differences in the rate of lymph node invasion in men with clinically localized prostate cancer might be related to the continent of origin. / Briganti, Alberto; Shariat, Shahrokh F.; Chun, Felix K H; Hutterer, Georg C.; Roehrborn, Claus G.; Gallina, Andrea; Rigatti, Patrizio; Valiquette, Luc; Montorsi, Francesco; Karakiewicz, Pierre I.

In: BJU International, Vol. 100, No. 3, 09.2007, p. 528-532.

Research output: Contribution to journalArticle

Briganti, A, Shariat, SF, Chun, FKH, Hutterer, GC, Roehrborn, CG, Gallina, A, Rigatti, P, Valiquette, L, Montorsi, F & Karakiewicz, PI 2007, 'Differences in the rate of lymph node invasion in men with clinically localized prostate cancer might be related to the continent of origin', BJU International, vol. 100, no. 3, pp. 528-532. https://doi.org/10.1111/j.1464-410X.2007.07005.x
Briganti, Alberto ; Shariat, Shahrokh F. ; Chun, Felix K H ; Hutterer, Georg C. ; Roehrborn, Claus G. ; Gallina, Andrea ; Rigatti, Patrizio ; Valiquette, Luc ; Montorsi, Francesco ; Karakiewicz, Pierre I. / Differences in the rate of lymph node invasion in men with clinically localized prostate cancer might be related to the continent of origin. In: BJU International. 2007 ; Vol. 100, No. 3. pp. 528-532.
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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.",
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T1 - Differences in the rate of lymph node invasion in men with clinically localized prostate cancer might be related to the continent of origin

AU - Briganti, Alberto

AU - Shariat, Shahrokh F.

AU - Chun, Felix K H

AU - Hutterer, Georg C.

AU - Roehrborn, Claus G.

AU - Gallina, Andrea

AU - Rigatti, Patrizio

AU - Valiquette, Luc

AU - Montorsi, Francesco

AU - Karakiewicz, Pierre I.

PY - 2007/9

Y1 - 2007/9

N2 - 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.

AB - 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.

KW - Lymph node invasion

KW - Pelvic lymphadenectomy

KW - Prostate cancer

KW - Radical prostatectomy

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