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Objective: assessing the predictive significance of clinical, histologic and biochemical factors for prediction of metastases in pelvic lymph nodes (MPLN), devising and validating of prognostic classification. Material and methods: the study enrolled 1140 patients subjected to radical prostatectomy (RPE) with standard pelvic lymphadenectomy for prostate adenocarcinoma: 865 of them at the classification devising stage and 275 in the course of validation. Results: according to the findings of multivariate logistic regression analysis, PSA level, the tumor cT stage and Gleason score are independent predictors of MPLN detection after RPE (p < 0.05). The prognostic factors were stratified by score for assessing the detection of regional metastases after RPE, depending on the combination of predictors. In the group of patients with a score estimate of prognostic factors < 10, the MPLN detection rate was significantly lower than in the group of patients with a score estimate > 15, accounting for 3.5 % and 23.7 % respectively (р < 0.0001). In the course of validating the obtained findings in clinic, metastatic involvement of pelvic lymph nodes found in the result of RPE was diagnosed in 40.0 % of the patients with a score estimate > 15 and only in 1.3 % of those with a total estimate of prognostic factors < 10 (р < 0.0001).

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Devising and external validation of a prognostic classification of metastatic involvement risk to pelvic lymph nodes in patients with newly diagnosed prostate cancer