Robotic-assisted pelvic lymph node dissection for XXXX : frequency of nodal metastases and oncological outcomes.

@entity1 @entity263 @entity342 @entity3
PURPOSE: Limited data are available regarding the oncologic efficacy of pelvic lymph node dissection (PLND) performed during robotic-assisted laparoscopic prostatectomy (RALP) for @entity263 . We aimed to determine the frequency of pelvic lymph node @entity3 and oncological outcomes following RALP with PLND in @entity1 who did not receive adjuvant @entity342 deprivation therapy (ADT). METHODS: We retrospectively reviewed the records of 1740 consecutive @entity1 who underwent RALP and extended PLND. The primary endpoint was biochemical recurrence (BCR). The estimated BCR probability was obtained using the Kaplan-Meier method. Cox proportional hazard regression models were used to assess for predictors of BCR. RESULTS: One hundred and eight @entity1 (6  %) with positive LNs were identified. The median number of LNs removed was 17 (IQR 11-24), and median follow-up was 26  months (IQR 14-43). Ninety-one (84  %) @entity1 did not receive adjuvant ADT of whom 60  % had BCR with a median time to recurrence of 8  months. The 1- and 3-year BCR-free probability was 42 and 28  %, respectively. @entity1 with  <=2 LN+ had significantly better biochemical-free estimated probability compared to those with >2 LN+ (p  =  0.002). The total number of LN+ (HR  =  1.1; 95  % CI 1.01-1.2, p  =  0.04) and Gleason 8-10 (HR  =  1.96; 95  % CI 1.1-3.4, p  =  0.02) were predictors of BCR on multivariate analysis. CONCLUSION: Among @entity1 with positive lymph nodes at time of robotic prostatectomy, those with two or fewer positive nodes and Gleason <8 exhibited favorable biochemical-free survival without adjuvant therapy.
