Management of pathological lymph node positive prostate cancer post radical prostatectomy: Recent experience from a single UK centre.
BAUS ePoster online library. King T. 06/30/16; 132009; P10-9
Mr. Thomas King
Mr. Thomas King
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Abstract
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P10-9

Introduction: Immediate ADT has previously been shown to improve CSS and OS in N+ disease after RP. In the present era of increased detection of microscopic nodal disease due to increasingly performed ePLND, this may represent over treatment for some patients. We present a series of patients with N+ disease managed either expectantly or with immediate ADT with a focus on early oncological outcomes.

Patients and Methods: Patients with N+ disease at RP were identified retrospectively from our database. Patients were either given immediate ADT or offered a period of PSA monitoring depending on disease characteristics and informed patient choice.

Results: 35 patients were identified with N+ disease, all except 4 had undergone ePLND as part of open RRP. Mean lymph node yield was 16(2-64). Overall median follow up was 38 months(8-110). 24 patients underwent PSA monitoring, 11 patients were given immediate ADT. Of those undergoing expectant management, median follow up was 25 months during which 29% required additional treatment for biochemical progression. In the immediate treatment group one patient died from PE 2 years post operatively. No other patient in either group developed clinical progression and the median PSA at most recent follow up in patients managed expectantly and with immediate ADT is 0.2 and <0.1 respectively.

Conclusion: In our small series, patients with N+ disease at RP managed with PSA surveillance had a low rate of biochemical progression and need for additional treatment at 2 years. Immediate ADT for N+ disease may be safely avoided in selected cases.

P10-9

Introduction: Immediate ADT has previously been shown to improve CSS and OS in N+ disease after RP. In the present era of increased detection of microscopic nodal disease due to increasingly performed ePLND, this may represent over treatment for some patients. We present a series of patients with N+ disease managed either expectantly or with immediate ADT with a focus on early oncological outcomes.

Patients and Methods: Patients with N+ disease at RP were identified retrospectively from our database. Patients were either given immediate ADT or offered a period of PSA monitoring depending on disease characteristics and informed patient choice.

Results: 35 patients were identified with N+ disease, all except 4 had undergone ePLND as part of open RRP. Mean lymph node yield was 16(2-64). Overall median follow up was 38 months(8-110). 24 patients underwent PSA monitoring, 11 patients were given immediate ADT. Of those undergoing expectant management, median follow up was 25 months during which 29% required additional treatment for biochemical progression. In the immediate treatment group one patient died from PE 2 years post operatively. No other patient in either group developed clinical progression and the median PSA at most recent follow up in patients managed expectantly and with immediate ADT is 0.2 and <0.1 respectively.

Conclusion: In our small series, patients with N+ disease at RP managed with PSA surveillance had a low rate of biochemical progression and need for additional treatment at 2 years. Immediate ADT for N+ disease may be safely avoided in selected cases.

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