Read Paper/Study on Radical Prostatectomy w/ Lymph Node Dissection (less as opposed to more /extended ) can’t find this study to read again

[Shorehousejam]

Does anyone have this study or paper that I briefly read on this topic and if it matters statistically of the amount of lymph nodes removed from surgery, ie: the amount of nodes removed over all compared to none, a few or extended.

And also about the amount of lymph nodes removed, when it comes to BCR, Longevity and Survival.

Found this excerpt:

How many lymph nodes are removed during radical prostatectomy?

Two studies reported that 81% and 83% of their patients had a 5-year survival (Masterson et al. and Toujier et al. respectively).

Both these studies remove a mean number of 9 lymph nodes and 12 lymph nodes respectively.

sages.org/meetings/annual-m...

Thank you

[Tall_Allen]

There are almost a hundred LNs in the pelvic drainage area, so no, it doesn't matter how many are removed, there will always be some that aren't. More to the point, with bone metastases having been found, your cancer is systemic.

[Shorehousejam in reply to Tall_Allen]

yes, we both know that it’s systemic we were looking to read that paper again,

Curious, have you reviewed any reports etc on surgery with lymph node removal ? In your prostate news letter? Objectivity is important

[Tall_Allen in reply to Shorehousejam]

try this:

prostatecancer.news/2020/12...

[Shorehousejam in reply to Tall_Allen]

Thank you, this is for radiation and this makes for some very good points, although it is up to each individual.

[Tall_Allen in reply to Shorehousejam]

Keep reading - it includes PLND too. There is no evidence of benefit.

[Shorehousejam in reply to Tall_Allen]

Yes, I read it

Like I said the Surgeon whom performed the surgery is very good and obviously on top of all recent data.

“Whole pelvic salvage radiation may be better than precisely targeted lymph node salvage radiation”

Agreed, There is another paper study that states the same as I’m explaining that lymphedema could be an issue with extended lymph node removal

[Shorehousejam]

found it Tall_Allen

karger.com/Article/FullText...

[Tall_Allen in reply to Shorehousejam]

That's in Japan, of course. In the US, sometimes surgeons take out a few, if any, and very few surgeons do ePLND because there is no evidence it makes a difference, while the side effects (lymphocele,lymphedema) can be serious.

[Shorehousejam in reply to Tall_Allen]

it’s amazing all the articles, research, studies…there is no conclusive information or evidence to be relied upon.

[Tall_Allen in reply to Shorehousejam]

There is no contradictory high quality evidence. That's why there is such a thing as "levels of evidence."

[Shorehousejam in reply to Tall_Allen]

Good point

[bean1008]

I had my RP in Dec 2018 but PSA began to rise by the following spring. Fall of 2019 I had an out of pocket PSMA scan at UCSF. Three lymph nodes lit up so March 2020 I had a PLND. The surgeon oversold (in my opinion) the possible benefit of lymph node removal and by fall 2020 my PSA began to rise again. Another PSMA in Oct 2020 showed three new nodes and a spot in my hip bone so started Lupron in Nov 2020 then Zytiga in Jan 2021. So was the lymph node removal beneficial? Who can say…but the ADT is working and I’ve been undetectable since Feb 2021. I think the PLND may have slowed things down but was not a cure.

[Shorehousejam in reply to bean1008]

I have been reading on it and it seems it’s a skim benefit in advanced prostate cancer, so less is more…there are tons of lymph nodes, it’s not possible to get them all, some may be micro metastatic,.. It seems many Surgeons will sell an extended eplnd as a curative intent that widely fails.

Positive surgical margins at the base, and not just the apex, with or with out SV invasion is a sign that bio chemical reoccurrence will be a predictable response within 18 months to 3 years depending on grade and Gleason score.

It seems so hopeless at times.

SBRT, salvage radiation is an option to pelvic area and bed.

Will it work, we hope so but we don’t know…

[bean1008]

I was really trying to avoid the radiation so took a chance on the PLND. Either way there could have been the micro issue so it’s pretty much impossible to ‘get it all’ through surgery or radiation. Luckily my ADT is working for now and there’s other tools (such as radiation) still in a future toolkit. Best wishes, Shorehouse!

[Shorehousejam in reply to bean1008]

Best Wishes to you!