FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W1520297934> ?p ?o ?g. }

• W1520297934 endingPage "470" @default.
• W1520297934 startingPage "469" @default.
• W1520297934 abstract "The role of prostatectomy in lymph node metastasized prostate cancer has been subject to changing opinions. Classically, a nodal dissection was performed as the initial step in the procedure and prostatectomy was avoided in men with cryosection-proven metastases. Biochemical recurrence during the first 3 years occurs in the majority of men with pN1 disease 1. Early data from randomized trials shows only a 50% prostate cancer-specific survival 12 years after prostatectomy and nodal metastases without immediate adjuvant treatment 2. Recently, Passoni et al. 3 showed a higher 10-year overall survival of 82.8% in men with nodal metastases, of whom the majority were treated with adjuvant androgen ablation and/or radiotherapy. This percentage is remarkably similar to the treatment arm of the earlier-mentioned study reported by Messing et al. 2, which showed a 10-year disease-specific survival of >80%. At 10 years about half the patients who died, did so from prostate cancer; therefore, although reasonable intermediate range survival can be obtained in men with nodal metastases of prostate cancer, the major cause of death remains prostate cancer when surgery is applied at the age of 65 years. Although adjuvant androgen ablation may improve survival, as suggested by the above-mentioned observations, some men may not experience recurrence after resection of nodal metastases and would experience the toxicity of androgen ablation unnecessarily. The identification of these men would reduce costs and toxicity. Passoni et al. 3 presented a multicentre study on prognostic factors after prostatectomy for node-positive disease. The number of removed nodes (median 10) seems relatively low compared with the 17 reported in their earlier single-centre study, but may be a good reflection of urological practice in general. By comparison, the percentage of men who underwent adjuvant radiotherapy in the multicentre study was low (16%). Data from da Pozzo et al. 4 suggest that adjuvant radiotherapy may be of benefit in men with limited nodal metastases. It would be of interest to study whether men with a later biochemical recurrence would be those that did experience recurrence only locally and therefore would be those most likely to benefit from adjuvant (or salvage) radiotherapy. In the current study by Passoni et al. 1 in the BJUI, the follow-up was relatively short (16 months). Earlier data from this author group showed that number of positive nodes and lymph node density were good predictors of cancer-specific survival after prostatectomy. This earlier observation is now confirmed in a multicentre analysis with a different endpoint: biochemical recurrence. What is notable is the fact that this confirmation was obtained in a series of patients with fewer nodes removed. The value of the marker ≤2 positive nodes becomes limited with the observation that this group contained 85% of men in their series. The second marker found, the size of the node, showed a more general distribution but as a single marker had no predictive value. The differences in Harrel's c values from the base model containing other clinical characteristics are limited and reproducibility of measures needs attention. Still, the observation that extent of nodal metastases is of prognostic value after surgery is notable. Ideally, markers could predict the absence of further disease progression in men after prostatectomy for nodal metastasized prostate cancer. None of the studied characteristics fulfill this need because at 36 months after prostatectomy the majority of men, even those in the best prognostic group, do experience biochemical recurrence that will result in prostate cancer-related death. Gleason score is a strong predictor of the presence of nodal metastases 5, and some have suggested that nodal Gleason grade is of prognostic value in men with pN+ disease. Until these markers have been further evaluated, it remains important to address the fact that reported cancer-specific survival in most men with pN+ disease is >10 years 6. Although tempting to speculate that prostatectomy and (extended) lymph node dissection plays a role in this, the almost inevitable development of biochemical recurrence reported in the current study by Passoni et al. 1, even in patients in the best prognostic group, stresses the systemic nature of this disease which will require a multimodality approach in most men at some point. None declared." @default.
• W1520297934 created "2016-06-24" @default.
• W1520297934 creator A5013864806 @default.
• W1520297934 date "2014-09-24" @default.
• W1520297934 modified "2023-10-02" @default.
• W1520297934 title "Extent of lymph node metastases" @default.
• W1520297934 cites W2123918450 @default.
• W1520297934 cites W2131176295 @default.
• W1520297934 cites W2138089669 @default.
• W1520297934 cites W2144312415 @default.
• W1520297934 cites W2147544484 @default.
• W1520297934 doi "https://doi.org/10.1111/bju.12392" @default.
• W1520297934 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/25256227" @default.
• W1520297934 hasPublicationYear "2014" @default.
• W1520297934 type Work @default.
• W1520297934 sameAs 1520297934 @default.
• W1520297934 citedByCount "0" @default.
• W1520297934 crossrefType "journal-article" @default.
• W1520297934 hasAuthorship W1520297934A5013864806 @default.
• W1520297934 hasConcept C121608353 @default.
• W1520297934 hasConcept C126322002 @default.
• W1520297934 hasConcept C126894567 @default.
• W1520297934 hasConcept C141071460 @default.
• W1520297934 hasConcept C143998085 @default.
• W1520297934 hasConcept C146357865 @default.
• W1520297934 hasConcept C151730666 @default.
• W1520297934 hasConcept C2775862295 @default.
• W1520297934 hasConcept C2776235491 @default.
• W1520297934 hasConcept C2779466945 @default.
• W1520297934 hasConcept C2780192828 @default.
• W1520297934 hasConcept C2780849966 @default.
• W1520297934 hasConcept C509974204 @default.
• W1520297934 hasConcept C71924100 @default.
• W1520297934 hasConcept C86803240 @default.
• W1520297934 hasConceptScore W1520297934C121608353 @default.
• W1520297934 hasConceptScore W1520297934C126322002 @default.
• W1520297934 hasConceptScore W1520297934C126894567 @default.
• W1520297934 hasConceptScore W1520297934C141071460 @default.
• W1520297934 hasConceptScore W1520297934C143998085 @default.
• W1520297934 hasConceptScore W1520297934C146357865 @default.
• W1520297934 hasConceptScore W1520297934C151730666 @default.
• W1520297934 hasConceptScore W1520297934C2775862295 @default.
• W1520297934 hasConceptScore W1520297934C2776235491 @default.
• W1520297934 hasConceptScore W1520297934C2779466945 @default.
• W1520297934 hasConceptScore W1520297934C2780192828 @default.
• W1520297934 hasConceptScore W1520297934C2780849966 @default.
• W1520297934 hasConceptScore W1520297934C509974204 @default.
• W1520297934 hasConceptScore W1520297934C71924100 @default.
• W1520297934 hasConceptScore W1520297934C86803240 @default.
• W1520297934 hasIssue "4" @default.
• W1520297934 hasLocation W15202979341 @default.
• W1520297934 hasLocation W15202979342 @default.
• W1520297934 hasOpenAccess W1520297934 @default.
• W1520297934 hasPrimaryLocation W15202979341 @default.
• W1520297934 hasRelatedWork W2154491681 @default.
• W1520297934 hasRelatedWork W2170401524 @default.
• W1520297934 hasRelatedWork W2305959020 @default.
• W1520297934 hasRelatedWork W2417374591 @default.
• W1520297934 hasRelatedWork W2590008096 @default.
• W1520297934 hasRelatedWork W2979919955 @default.
• W1520297934 hasRelatedWork W3021750807 @default.
• W1520297934 hasRelatedWork W3087899116 @default.
• W1520297934 hasRelatedWork W4313530623 @default.
• W1520297934 hasRelatedWork W93186087 @default.
• W1520297934 hasVolume "114" @default.
• W1520297934 isParatext "false" @default.
• W1520297934 isRetracted "false" @default.
• W1520297934 magId "1520297934" @default.
• W1520297934 workType "article" @default.