Prostate cancer topography and patterns of lymph node metastasis Journal Article


Authors: Tokuda, Y.; Carlino, L. J.; Gopalan, A.; Tickoo, S. K.; Kaag, M. G.; Guillonneau, B.; Eastham, J. A.; Scher, H. I.; Scardino, P. T.; Reuter, V. E.; Fine, S. W.
Article Title: Prostate cancer topography and patterns of lymph node metastasis
Abstract: Pelvic lymph node (LN) metastasis is a well-recognized route of prostate cancer spread. However, the relationship between topography and the pathologic features of primary prostatic cancers and patterns of pelvic LN metastasis has not been well studied. We reviewed original slides of radical prostatectomies and pelvic LN dissections from 125 patients with LN metastasis and recorded a total number of LN excised/laterality of positive LN, and localization, staging parameters, lymphovascular invasion, and volume of primary tumors. LN QUANTITY AND DISTRIBUTION: 14.6 (mean) and 13 (median) LNs were resected. Seventy-six (61%), 33 (26%), and 16 (13%) cases had 1, 2, and >2 positive LNs; whereas 58, 44, and 20 cases had LN metastasis on the right, left, and bilaterally. PATHOLOGIC FEATURES: Eighty-six percent (108 of 125) and 37% (46 of 125) of the cases showed extraprostatic extension and seminal vesicle invasion, whereas 64% cased showed lymphovascular invasion. Mean and median total tumor volumes were 6.39 and 3.92 cm, with 50% and 90% Gleason patterns 4/5 in 105 (84%) and 73 (58%) cases, respectively. Correlation with Dominant Tumor Location: Dominant lesions on radical prostatectomy were as follows: 50 right lobe, 44 left lobe, and 31 bilateral lobe tumors. Fifteen of 50 (30%) right lobe and 18 of 44 (41%) left lobe dominant tumors had LN metastasis on the contralateral side. Only 4% (5 of 125) of the cases were associated with anterior dominant tumors. CONCLUSION: Thirty percent to 40% of LN metastases occurred contralateral to the dominant tumor. LN metastasis is overwhelmingly associated with high-grade, high-stage, and large volume disease. LN positivity is rarely associated with anterior dominant tumors. © 2010 by Lippincott Williams & Wilkins.
Keywords: retrospective studies; lymph node metastasis; lymph nodes; lymphatic metastasis; adenocarcinoma; metastasis; pathology; retrospective study; prostatic neoplasms; prostate; prostatectomy; lymph node; prostate tumor; topography; anterior tumor; lymphovascular invasion; pelvic lymph node
Journal Title: American Journal of Surgical Pathology
Volume: 34
Issue: 12
ISSN: 0147-5185
Publisher: Lippincott Williams & Wilkins  
Date Published: 2010-12-01
Start Page: 1862
End Page: 1867
Language: English
DOI: 10.1097/PAS.0b013e3181fc679e
PUBMED: 21107093
PROVIDER: scopus
PMCID: PMC3414911
DOI/URL:
Notes: --- - "Export Date: 20 April 2011" - "CODEN: AJSPD" - "Source: Scopus"
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MSK Authors
  1. Peter T Scardino
    671 Scardino
  2. Satish K Tickoo
    483 Tickoo
  3. Yuji Tokuda
    3 Tokuda
  4. Matthew G Kaag
    32 Kaag
  5. Anuradha Gopalan
    416 Gopalan
  6. James Eastham
    537 Eastham
  7. Samson W Fine
    462 Fine
  8. Victor Reuter
    1228 Reuter
  9. Howard Scher
    1130 Scher