Premium
Increased Survival of Patients with Massive Lymphadenopathy and Prostate Cancer: Evidence of Heterogeneous Tumour Behaviour
Author(s) -
SANDHU D. P. S.,
MAYOR P. E.,
SAMBROOK P.,
GEORGE N. J. R.
Publication year - 1990
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1990.tb14965.x
Subject(s) - medicine , lymph node , prostate cancer , stage (stratigraphy) , disease , prostate , cancer , lymphatic system , radiology , oncology , surgery , pathology , paleontology , biology
Summary— The survival of patients with prostate cancer and radiologically detectable lymph node enlargement has been studied prospectively over an 8‐year period. Computed tomography in 108 patients presenting with symptoms, signs or biochemical results suggesting lymphatic spread revealed pelvic or abdominal node masses in 60 patients; in 29 (48%), the masses measured more than 4 cm and the maximum node diameter was 15 cm. Two‐thirds of patients had advanced (T3/T4) tumour stage. Following treatment, actuarial survival in all 60 patients with nodal enlargement was 40% at 5 years. Within this group, survival in 22 patients with lymphadenopathy but negative bone scans at diagnosis was significantly better than that of 38 patients with both node and bone disease (70% vs 20% at 5 years). This improvement was related both to an apparent inability of certain tumours initially to progress and seed within bone and to a marked sensitivity of the node masses to subsequent hormonal manipulation. Primary tumour grade was proportionally similar in both groups. Unexpectedly, 6 of the 38 patients with combined disease obtained a complete remission after treatment. The reason for this heterogeneous biological behaviour remains unclear; but these observations underscore the importance of vigorous treatment in all patients with advanced lymph node disease.