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Abstract：
UNASSIGNED: The aim of the study is to evaluate the effect of deferred androgen deprivation therapy on biochemical recurrence (BCR) and other survival parameters in node-positive prostate cancer patients after robot-assisted radical prostatectomy with bilateral extended pelvic lymph node dissection (RARP + EPLND).
UNASSIGNED: Of the 453 consecutive RARP procedures performed from 2011 to 2018, 100 patients with no prior use of androgen deprivation therapy were found to be lymph node (LN) positive and were observed, with initiation of salvage treatment at the time of BCR only. Patients were divided into 1 or 2 LNs (67)-and more than 2 LNs (33)-positive groups to assess survival outcomes.
UNASSIGNED: At a median follow-up of 21 months (1-70 months), the LN group (p < 0.000), preoperative prostate-specific antigen (PSA, p = 0.013), tumor volume (TV, p = 0.031), and LND (p = 0.004) were significantly associated with BCR. In multivariate analysis, only the LN group (p = 0.035) and PSA level (p = 0.026) were statistically significant. The estimated BCR-free survival rates in the 1/2 LN group were 37.6% (27%-52.2%), 26.5% (16.8%-41.7%), and 19.9% (9.6%-41.0%) at 1, 3, and 5 years, respectively, with a hazard of developing BCR of 0.462 (0.225-0.948) compared with the more than 2 LN-positive group. Estimated 5-year overall survival, cancer-specific, metastasis-free, and local recurrence-free survival rates were 88.4% (73.1%-100%), 89.5% (74%-100%), 65.1% (46.0%-92.1%), and 94.8% (87.2%-100.0%), respectively, for which none of the factors were significant. Based on cutoff values for PSA, TV, and LND of 30 ng/mL, 30%, and 10%, respectively, the 1/2 LN group was substratified, wherein the median BCR-free survival for the low- and intermediate-risk groups was 40 and 12 months, respectively.
UNASSIGNED: Nearly one fourth and one fifth of 1/2 node-positive patients were BCR-free at 3 and 5 years after RARP + EPLND. Further substratification using PSA, TV, and LN density may help in providing individualized care regarding the initiation of adjuvant therapy.
UNASSIGNED: Of the 453 consecutive RARP procedures performed from 2011 to 2018, 100 patients with no prior use of androgen deprivation therapy were found to be lymph node (LN) positive and were observed, with initiation of salvage treatment at the time of BCR only. Patients were divided into 1 or 2 LNs (67)-and more than 2 LNs (33)-positive groups to assess survival outcomes.
UNASSIGNED: At a median follow-up of 21 months (1-70 months), the LN group (p < 0.000), preoperative prostate-specific antigen (PSA, p = 0.013), tumor volume (TV, p = 0.031), and LND (p = 0.004) were significantly associated with BCR. In multivariate analysis, only the LN group (p = 0.035) and PSA level (p = 0.026) were statistically significant. The estimated BCR-free survival rates in the 1/2 LN group were 37.6% (27%-52.2%), 26.5% (16.8%-41.7%), and 19.9% (9.6%-41.0%) at 1, 3, and 5 years, respectively, with a hazard of developing BCR of 0.462 (0.225-0.948) compared with the more than 2 LN-positive group. Estimated 5-year overall survival, cancer-specific, metastasis-free, and local recurrence-free survival rates were 88.4% (73.1%-100%), 89.5% (74%-100%), 65.1% (46.0%-92.1%), and 94.8% (87.2%-100.0%), respectively, for which none of the factors were significant. Based on cutoff values for PSA, TV, and LND of 30 ng/mL, 30%, and 10%, respectively, the 1/2 LN group was substratified, wherein the median BCR-free survival for the low- and intermediate-risk groups was 40 and 12 months, respectively.
UNASSIGNED: Nearly one fourth and one fifth of 1/2 node-positive patients were BCR-free at 3 and 5 years after RARP + EPLND. Further substratification using PSA, TV, and LN density may help in providing individualized care regarding the initiation of adjuvant therapy.
摘要：
UNASSIGNED：本研究的目的是评估延期雄激素剥夺治疗对机器人辅助前列腺癌根治术伴双侧盆腔淋巴结清扫术（RARP+EPLND）后淋巴结阳性前列腺癌患者生化复发（BCR）和其他生存参数的影响。
UNASSIGNED：在2011年至2018年进行的453例连续RARP手术中，发现100例未使用雄激素剥夺疗法的患者淋巴结（LN）阳性，并观察到，仅在BCR时开始抢救治疗。将患者分为1或2个LN（67）和2个以上的LN（33）阳性组以评估生存结果。
未经评估：在中位随访21个月（1-70个月）时，LN组(p<0.000)，术前前列腺特异性抗原（PSA，p=0.013),肿瘤体积(TV，p=0.031),LND(p=0.004)与BCR显著相关。在多变量分析中，只有LN组(p=0.035)和PSA水平(p=0.026)有统计学意义。1/2LN组的无BCR生存率估计为37.6%(27%-52.2%),26.5%（16.8%-41.7%），1年、3年和5年为19.9%(9.6%-41.0%)，分别,与超过2LN阳性组相比，发展BCR的风险为0.462（0.225-0.948）。估计5年总生存率，癌症特异性，无转移,无局部复发生存率为88.4%(73.1%-100%),89.5%（74%-100%），65.1%（46.0%-92.1%），和94.8%(87.2%-100.0%)，分别,其中没有一个因素是显著的。根据PSA的截止值，电视,LND为30ng/mL，30%,10%,分别,对1/2LN组进行了细分，其中低危组和中危组的中位无BCR生存期为40个月和12个月，分别。
未经证实：在RARP+EPLND后3年和5年，近四分之一和五分之一的1/2节点阳性患者无BCR。使用PSA进一步细分，电视,和LN密度可能有助于提供有关辅助治疗开始的个性化护理。
UNASSIGNED：在2011年至2018年进行的453例连续RARP手术中，发现100例未使用雄激素剥夺疗法的患者淋巴结（LN）阳性，并观察到，仅在BCR时开始抢救治疗。将患者分为1或2个LN（67）和2个以上的LN（33）阳性组以评估生存结果。
未经评估：在中位随访21个月（1-70个月）时，LN组(p<0.000)，术前前列腺特异性抗原（PSA，p=0.013),肿瘤体积(TV，p=0.031),LND(p=0.004)与BCR显著相关。在多变量分析中，只有LN组(p=0.035)和PSA水平(p=0.026)有统计学意义。1/2LN组的无BCR生存率估计为37.6%(27%-52.2%),26.5%（16.8%-41.7%），1年、3年和5年为19.9%(9.6%-41.0%)，分别,与超过2LN阳性组相比，发展BCR的风险为0.462（0.225-0.948）。估计5年总生存率，癌症特异性，无转移,无局部复发生存率为88.4%(73.1%-100%),89.5%（74%-100%），65.1%（46.0%-92.1%），和94.8%(87.2%-100.0%)，分别,其中没有一个因素是显著的。根据PSA的截止值，电视,LND为30ng/mL，30%,10%,分别,对1/2LN组进行了细分，其中低危组和中危组的中位无BCR生存期为40个月和12个月，分别。
未经证实：在RARP+EPLND后3年和5年，近四分之一和五分之一的1/2节点阳性患者无BCR。使用PSA进一步细分，电视,和LN密度可能有助于提供有关辅助治疗开始的个性化护理。
