Pelvic lymphadenectomy can be omitted in selected patients with carcinoma of the prostate: development of a system of patient selection
Objectives. The prevalence of pelvic lymph node metastases in men with clinically localized prostate cancer has decreased dramatically over the past decade, possibly due to efforts at early detection. With a significantly lower incidence of pelvic node involvement, it may be possible to identify a s...
Gespeichert in:
| Veröffentlicht in: | Urology (Ridgewood, N.J.) N.J.), 1995-02, Vol.45 (2), p.270-274 |
|---|---|
| Hauptverfasser: | , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 274 |
|---|---|
| container_issue | 2 |
| container_start_page | 270 |
| container_title | Urology (Ridgewood, N.J.) |
| container_volume | 45 |
| creator | Bishoff, Jay T. Reyes, Antonio Thompson, Ian M. Harris, Michael J. St Clair, Stephen R. Gomella, Leonard Butzin, Clifford A. |
| description | Objectives. The prevalence of pelvic lymph node metastases in men with clinically localized prostate cancer has decreased dramatically over the past decade, possibly due to efforts at early detection. With a significantly lower incidence of pelvic node involvement, it may be possible to identify a segment of patients for whom pelvic lymph node dissection (PLND) may be omitted. This study was conducted to develop a method to select patients for whom PLND could be omitted.
Methods. We analyzed serum prostate-specific antigen (PSA), clinical stage, biopsy Gleason score, and final pathologic stage in 481 men with clinically localized prostate cancer. These variables were compared to the risk of positive pelvic lymph nodes.
Results. Logistic regression analysis determined that combining all three variables provided the best determination of final pathologic stage. A series of probability curves have been created to estimate the risk of positive lymph nodes in a given patient. Based on the distribution of patients in this study and using these probability functions, PLND could be avoided in up to 50% of patients with localized prostate cancer diagnosed by contemporary methods.
Conclusions. In properly selected patients, pelvic lymphadenectomy can be omitted in the staging and treatment of localized prostate cancer. |
| doi_str_mv | 10.1016/0090-4295(95)80017-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_77146958</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>0090429595800174</els_id><sourcerecordid>77146958</sourcerecordid><originalsourceid>FETCH-LOGICAL-c386t-5da0a7eedb4129a02f8334c266211d25fdef515ca4d521ec639f57df429c18c53</originalsourceid><addsrcrecordid>eNp9kNFqHCEUhqWkJJs0b9CCF6G0F5PqjDpjLwolpGkh0F4k1-LqkbWM42R0t-wT5LXrZIe9DAgK_3d-jh9C7ym5poSKL4RIUrFa8k-Sf-4IoW3F3qAV5XVbSSn5CVodkTN0ntJfQogQoj1Fpy1vqCR0hZ7_QL_zBvf7MG60hQFMjmGPjR7wGnAMPmew2A84QV-y8h519jDkhP_5vCngZPwQg8bR4bwBPE4xZZ3hK7awgz6OocBzqHHapwxhfi8dS6mPwzv01uk-weVyX6DHH7cPNz-r-993v26-31em6USuuNVEtwB2zWgtNald1zTM1ELUlNqaOwuOU240s7ymYEQjHW-tKw4M7QxvLtDHQ29Z82kLKavgk4G-1wPEbVJtS5mQvCsgO4Cm_CdN4NQ4-aCnvaJEzf7VLFfNclU5L_4VK2Mflv7tOoA9Di3CS3615DoZ3btJD8anI9Yw0gkxr_ntgEFxsfMwqWSKMAPWT0WYstG_vsd_1cSj0w</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>77146958</pqid></control><display><type>article</type><title>Pelvic lymphadenectomy can be omitted in selected patients with carcinoma of the prostate: development of a system of patient selection</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Bishoff, Jay T. ; Reyes, Antonio ; Thompson, Ian M. ; Harris, Michael J. ; St Clair, Stephen R. ; Gomella, Leonard ; Butzin, Clifford A.</creator><creatorcontrib>Bishoff, Jay T. ; Reyes, Antonio ; Thompson, Ian M. ; Harris, Michael J. ; St Clair, Stephen R. ; Gomella, Leonard ; Butzin, Clifford A.</creatorcontrib><description>Objectives. The prevalence of pelvic lymph node metastases in men with clinically localized prostate cancer has decreased dramatically over the past decade, possibly due to efforts at early detection. With a significantly lower incidence of pelvic node involvement, it may be possible to identify a segment of patients for whom pelvic lymph node dissection (PLND) may be omitted. This study was conducted to develop a method to select patients for whom PLND could be omitted.
Methods. We analyzed serum prostate-specific antigen (PSA), clinical stage, biopsy Gleason score, and final pathologic stage in 481 men with clinically localized prostate cancer. These variables were compared to the risk of positive pelvic lymph nodes.
Results. Logistic regression analysis determined that combining all three variables provided the best determination of final pathologic stage. A series of probability curves have been created to estimate the risk of positive lymph nodes in a given patient. Based on the distribution of patients in this study and using these probability functions, PLND could be avoided in up to 50% of patients with localized prostate cancer diagnosed by contemporary methods.
Conclusions. In properly selected patients, pelvic lymphadenectomy can be omitted in the staging and treatment of localized prostate cancer.</description><identifier>ISSN: 0090-4295</identifier><identifier>EISSN: 1527-9995</identifier><identifier>DOI: 10.1016/0090-4295(95)80017-4</identifier><identifier>PMID: 7531901</identifier><identifier>CODEN: URGYAZ</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Biological and medical sciences ; Humans ; Logistic Models ; Lymph Node Excision ; Lymphatic Metastasis ; Male ; Medical sciences ; Neoplasm Staging ; Nephrology. Urinary tract diseases ; Patient Selection ; Prostate-Specific Antigen ; Prostatic Neoplasms - blood ; Prostatic Neoplasms - pathology ; Prostatic Neoplasms - surgery ; Risk Factors ; Tumors of the urinary system ; Urinary tract. Prostate gland</subject><ispartof>Urology (Ridgewood, N.J.), 1995-02, Vol.45 (2), p.270-274</ispartof><rights>1995</rights><rights>1995 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c386t-5da0a7eedb4129a02f8334c266211d25fdef515ca4d521ec639f57df429c18c53</citedby><cites>FETCH-LOGICAL-c386t-5da0a7eedb4129a02f8334c266211d25fdef515ca4d521ec639f57df429c18c53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/0090429595800174$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3408665$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7531901$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bishoff, Jay T.</creatorcontrib><creatorcontrib>Reyes, Antonio</creatorcontrib><creatorcontrib>Thompson, Ian M.</creatorcontrib><creatorcontrib>Harris, Michael J.</creatorcontrib><creatorcontrib>St Clair, Stephen R.</creatorcontrib><creatorcontrib>Gomella, Leonard</creatorcontrib><creatorcontrib>Butzin, Clifford A.</creatorcontrib><title>Pelvic lymphadenectomy can be omitted in selected patients with carcinoma of the prostate: development of a system of patient selection</title><title>Urology (Ridgewood, N.J.)</title><addtitle>Urology</addtitle><description>Objectives. The prevalence of pelvic lymph node metastases in men with clinically localized prostate cancer has decreased dramatically over the past decade, possibly due to efforts at early detection. With a significantly lower incidence of pelvic node involvement, it may be possible to identify a segment of patients for whom pelvic lymph node dissection (PLND) may be omitted. This study was conducted to develop a method to select patients for whom PLND could be omitted.
Methods. We analyzed serum prostate-specific antigen (PSA), clinical stage, biopsy Gleason score, and final pathologic stage in 481 men with clinically localized prostate cancer. These variables were compared to the risk of positive pelvic lymph nodes.
Results. Logistic regression analysis determined that combining all three variables provided the best determination of final pathologic stage. A series of probability curves have been created to estimate the risk of positive lymph nodes in a given patient. Based on the distribution of patients in this study and using these probability functions, PLND could be avoided in up to 50% of patients with localized prostate cancer diagnosed by contemporary methods.
Conclusions. In properly selected patients, pelvic lymphadenectomy can be omitted in the staging and treatment of localized prostate cancer.</description><subject>Biological and medical sciences</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Lymph Node Excision</subject><subject>Lymphatic Metastasis</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Neoplasm Staging</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Patient Selection</subject><subject>Prostate-Specific Antigen</subject><subject>Prostatic Neoplasms - blood</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Prostatic Neoplasms - surgery</subject><subject>Risk Factors</subject><subject>Tumors of the urinary system</subject><subject>Urinary tract. Prostate gland</subject><issn>0090-4295</issn><issn>1527-9995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1995</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kNFqHCEUhqWkJJs0b9CCF6G0F5PqjDpjLwolpGkh0F4k1-LqkbWM42R0t-wT5LXrZIe9DAgK_3d-jh9C7ym5poSKL4RIUrFa8k-Sf-4IoW3F3qAV5XVbSSn5CVodkTN0ntJfQogQoj1Fpy1vqCR0hZ7_QL_zBvf7MG60hQFMjmGPjR7wGnAMPmew2A84QV-y8h519jDkhP_5vCngZPwQg8bR4bwBPE4xZZ3hK7awgz6OocBzqHHapwxhfi8dS6mPwzv01uk-weVyX6DHH7cPNz-r-993v26-31em6USuuNVEtwB2zWgtNald1zTM1ELUlNqaOwuOU240s7ymYEQjHW-tKw4M7QxvLtDHQ29Z82kLKavgk4G-1wPEbVJtS5mQvCsgO4Cm_CdN4NQ4-aCnvaJEzf7VLFfNclU5L_4VK2Mflv7tOoA9Di3CS3615DoZ3btJD8anI9Yw0gkxr_ntgEFxsfMwqWSKMAPWT0WYstG_vsd_1cSj0w</recordid><startdate>19950201</startdate><enddate>19950201</enddate><creator>Bishoff, Jay T.</creator><creator>Reyes, Antonio</creator><creator>Thompson, Ian M.</creator><creator>Harris, Michael J.</creator><creator>St Clair, Stephen R.</creator><creator>Gomella, Leonard</creator><creator>Butzin, Clifford A.</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19950201</creationdate><title>Pelvic lymphadenectomy can be omitted in selected patients with carcinoma of the prostate: development of a system of patient selection</title><author>Bishoff, Jay T. ; Reyes, Antonio ; Thompson, Ian M. ; Harris, Michael J. ; St Clair, Stephen R. ; Gomella, Leonard ; Butzin, Clifford A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c386t-5da0a7eedb4129a02f8334c266211d25fdef515ca4d521ec639f57df429c18c53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1995</creationdate><topic>Biological and medical sciences</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Lymph Node Excision</topic><topic>Lymphatic Metastasis</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Neoplasm Staging</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Patient Selection</topic><topic>Prostate-Specific Antigen</topic><topic>Prostatic Neoplasms - blood</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Prostatic Neoplasms - surgery</topic><topic>Risk Factors</topic><topic>Tumors of the urinary system</topic><topic>Urinary tract. Prostate gland</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bishoff, Jay T.</creatorcontrib><creatorcontrib>Reyes, Antonio</creatorcontrib><creatorcontrib>Thompson, Ian M.</creatorcontrib><creatorcontrib>Harris, Michael J.</creatorcontrib><creatorcontrib>St Clair, Stephen R.</creatorcontrib><creatorcontrib>Gomella, Leonard</creatorcontrib><creatorcontrib>Butzin, Clifford A.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Urology (Ridgewood, N.J.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bishoff, Jay T.</au><au>Reyes, Antonio</au><au>Thompson, Ian M.</au><au>Harris, Michael J.</au><au>St Clair, Stephen R.</au><au>Gomella, Leonard</au><au>Butzin, Clifford A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pelvic lymphadenectomy can be omitted in selected patients with carcinoma of the prostate: development of a system of patient selection</atitle><jtitle>Urology (Ridgewood, N.J.)</jtitle><addtitle>Urology</addtitle><date>1995-02-01</date><risdate>1995</risdate><volume>45</volume><issue>2</issue><spage>270</spage><epage>274</epage><pages>270-274</pages><issn>0090-4295</issn><eissn>1527-9995</eissn><coden>URGYAZ</coden><abstract>Objectives. The prevalence of pelvic lymph node metastases in men with clinically localized prostate cancer has decreased dramatically over the past decade, possibly due to efforts at early detection. With a significantly lower incidence of pelvic node involvement, it may be possible to identify a segment of patients for whom pelvic lymph node dissection (PLND) may be omitted. This study was conducted to develop a method to select patients for whom PLND could be omitted.
Methods. We analyzed serum prostate-specific antigen (PSA), clinical stage, biopsy Gleason score, and final pathologic stage in 481 men with clinically localized prostate cancer. These variables were compared to the risk of positive pelvic lymph nodes.
Results. Logistic regression analysis determined that combining all three variables provided the best determination of final pathologic stage. A series of probability curves have been created to estimate the risk of positive lymph nodes in a given patient. Based on the distribution of patients in this study and using these probability functions, PLND could be avoided in up to 50% of patients with localized prostate cancer diagnosed by contemporary methods.
Conclusions. In properly selected patients, pelvic lymphadenectomy can be omitted in the staging and treatment of localized prostate cancer.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>7531901</pmid><doi>10.1016/0090-4295(95)80017-4</doi><tpages>5</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0090-4295 |
| ispartof | Urology (Ridgewood, N.J.), 1995-02, Vol.45 (2), p.270-274 |
| issn | 0090-4295 1527-9995 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_77146958 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Biological and medical sciences Humans Logistic Models Lymph Node Excision Lymphatic Metastasis Male Medical sciences Neoplasm Staging Nephrology. Urinary tract diseases Patient Selection Prostate-Specific Antigen Prostatic Neoplasms - blood Prostatic Neoplasms - pathology Prostatic Neoplasms - surgery Risk Factors Tumors of the urinary system Urinary tract. Prostate gland |
| title | Pelvic lymphadenectomy can be omitted in selected patients with carcinoma of the prostate: development of a system of patient selection |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-26T02%3A29%3A10IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Pelvic%20lymphadenectomy%20can%20be%20omitted%20in%20selected%20patients%20with%20carcinoma%20of%20the%20prostate:%20development%20of%20a%20system%20of%20patient%20selection&rft.jtitle=Urology%20(Ridgewood,%20N.J.)&rft.au=Bishoff,%20Jay%20T.&rft.date=1995-02-01&rft.volume=45&rft.issue=2&rft.spage=270&rft.epage=274&rft.pages=270-274&rft.issn=0090-4295&rft.eissn=1527-9995&rft.coden=URGYAZ&rft_id=info:doi/10.1016/0090-4295(95)80017-4&rft_dat=%3Cproquest_cross%3E77146958%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=77146958&rft_id=info:pmid/7531901&rft_els_id=0090429595800174&rfr_iscdi=true |