Prognosis of patients with lymph node positive prostate cancer following radical prostatectomy: long-term resultsSiamak Daneshmand et al. J Urol. 2004 Dec. Show
AbstractPurpose: We determined the prognostic factors that affect recurrence and survival in patients with lymph node positive prostate cancer. Materials and methods: Between 1972 and 1999, 1,936 patients underwent radical retropubic prostatectomy and pelvic lymph node dissection for clinically organ confined prostate cancer. A total of 235 patients (12.1%) were found to have disease metastatic to the lymph nodes (stage D1). Of the patients 69% received no adjuvant treatment. We reviewed the tumor stage (TNM), Gleason score, number and percent of involved lymph nodes (lymph node density), preoperative prostate specific antigen when available and adjuvant treatment. Overall survival and recurrence-free survival were estimated using Kaplan-Meier plots. Results: Followup was 1 to 24 years (median 11.4). Overall median survival was 15 years. Overall clinical recurrence-free survival at 5, 10 and 15 years was 80%, 65% and 58%, respectively. Patients who had 1 or 2 positive lymph nodes had a clinical recurrence-free survival of 70% and 73% at 10 years, respectively, vs 49% in those who had 5 or more involved lymph nodes (p = 0.0031). When stratified by lymph node density, patients with a lymph node density of 20% or greater were at higher risk for clinical recurrence compared to those with a density of less than 20% (relative risk = 2.32, p <0.0001). On stratified log rank test only prostate cancer T stage, and the number and percent of positive lymph nodes correlated with recurrence-free and overall survival. Conclusions: Local tumor bulk and the number/percent of involved lymph nodes significantly affect disease progression and the survival rate. Radical prostatectomy may offer long-term survival in patients who have limited tumor bulk and nodal involvement. Comment in
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What is the prognosis when cancer has spread to the lymph nodes?However, if the cancer spreads to the lymph nodes, this rate drops to 30–60%. The survival rate refers to the proportion of people who are still alive for a length of time after receiving a particular diagnosis.
Is cancer terminal if in lymph nodes?"In general, cancers that have spread to the lymph nodes are typically stage 2 or 3," says Juan Santamaria, MD, Nebraska Medicine surgical oncologist. "Many of these cancers are still treatable and even curable at this stage.
What stage is cancer when it spreads to lymph nodes?stage 3 – the cancer is larger and may have spread to the surrounding tissues and/or the lymph nodes (or "glands", part of the immune system)
How do you treat cancer that has spread to lymph nodes?Treatment for cancer in the lymph nodes
Surgery may be used to treat some forms of metastatic cancer that has spread to the lymph nodes. Other treatment options for cancer in the lymph nodes may include chemotherapy, radiation therapy, a stem cell transplant, immunotherapy or targeted therapy.
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