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- W2349357777 abstract "The observed decline in population-based prostate-specific antigen (PSA) screening and incidence of early stage prostate cancer (PCa) following the 2012 US Preventive Services Task Force screening recommendations together with continuing increase in life expectancy are destined to yield an increased rate of men with advanced disease at presentation [1]. There is every reason to believe that the benefit of reducing overtreatment might be offset by facing a larger proportion of men who harbor lymph node metastasis (LNM) at time of surgery. The optimal clinical approach and the role of surgery for pathologically detected nodal disease have yet to be established. Consequently, from diagnostic, therapeutic, and research perspectives, an adequate pelvic lymph node dissection (PLND) in men at high risk for LNM remains paramount. It is within this context that quality metrics for PLND and treatment strategies for node-positive patients are being pursued constantly. In this month’s issue of European Urology Focus, Mandel and colleagues analyzed the oncologic outcomes of men with node-positive PCa who underwent radical prostatectomy [2]. The authors demonstrated that the number of positive nodes, but not the overall lymph node count, is an important prognosticator. The latter was not associated with oncologic outcomes and thus, as the authors suggest, should not be used as a prognostic factor or surrogate for surgical quality. Substantiating the tenets of the TNM staging system, Mandel et al [2] and others [3,4] supported the evidence showing that the higher the burden of nodal disease, the more likely the patient is to succumb to his cancer. In the absence of predictable routes of lymphatic spread, it is also reasonable to assume that the greater the" @default.
- W2349357777 created "2016-06-24" @default.
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- W2349357777 date "2017-04-01" @default.
- W2349357777 modified "2023-10-16" @default.
- W2349357777 title "Curing Lymph Node Metastasis in Prostate Cancer: The Ongoing Battle Between Improving Surgical Quality and Tumor Biology" @default.
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- W2349357777 doi "https://doi.org/10.1016/j.euf.2016.04.004" @default.
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