WASHINGTON -- Extended pelvic lymph node dissection (ePLND) after radical prostatectomy failed to improve survival in intermediate- and high-risk prostate cancer over standard lymphadenectomy, long-term follow-up from a randomized trial showed.
After a median follow-up of almost 11 years, more extensive lymph node assessment did not significantly improve any survival outcome in the overall patient population, as compared with limited PLND (lPLND). A subgroup analysis suggested that patients with high-grade disease (grade group [GG] 3-5) might have better biochemical relapse-free survival (BRFS), consistent with an earlier analysis, and after additional follow-up, patients with high-grade disease might also have better metastasis-free survival (MFS) with ePLND.
"This phase III randomized, controlled trial did not demonstrate oncological superiority of extended pelvic lymph node dissection over limited pelvic lymph node dissection among unselected intermediate- and high-risk prostate cancer patients," said Jean Lestingi, MD, of the University of Sao Paolo in Brazil, at the American Urological Association (AUA) meeting. "In patients with biopsies of grade group 3-5, after a long-term follow-up, a significant and sustainable benefit in biochemical recurrence-free survival was shown and we now demonstrate the benefits in metastasis-free survival."
