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Contemporary Incidence and Outcomes of Prostate Cancer Lymph Node Metastases.

Abstract The incidence of localized prostate cancer has decreased with shifts in prostate cancer screening. While recent population based studies demonstrated a stable incidence of locoregional prostate cancer, they categorized organ confined, extraprostatic and lymph node positive disease together. However, to our knowledge the contemporary incidence of prostate cancer with pelvic lymph node metastases remains unknown.
PMID
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Authors

Mayor MeshTerms
Keywords

SEER Program

mortality

neoplasm metastasis

practice guidelines as topic

prostatic neoplasms

Journal Title the journal of urology
Publication Year Start




PMID- 29288121
OWN - NLM
STAT- Publisher
LR  - 20180305
IS  - 1527-3792 (Electronic)
IS  - 0022-5347 (Linking)
DP  - 2017 Dec 26
TI  - Contemporary Incidence and Outcomes of Prostate Cancer Lymph Node Metastases.
LID - S0022-5347(17)78181-5 [pii]
LID - 10.1016/j.juro.2017.12.048 [doi]
AB  - PURPOSE: The incidence of localized prostate cancer has decreased with shifts in 
      prostate cancer screening. While recent population based studies demonstrated a
      stable incidence of locoregional prostate cancer, they categorized organ
      confined, extraprostatic and lymph node positive disease together. However, to
      our knowledge the contemporary incidence of prostate cancer with pelvic lymph
      node metastases remains unknown. MATERIALS AND METHODS: We used SEER
      (Surveillance, Epidemiology and End Results) from 2004 to 2014 to identify men
      diagnosed with prostate cancer. We analyzed trends in the age standardized
      prostate cancer incidence by stage. The impact of disease extent on mortality was
      assessed by adjusted Cox proportional hazard analysis. RESULTS: During the study 
      period the annual incidence of nonmetastatic prostate cancer decreased from
      5119.1 to 2931.9 per million men (IR 0.57, 95% CI 0.56-0.58, p <0.01) while the
      incidence of pelvic lymph node metastases increased from 54.1 to 79.5 per million
      men (IR 1.47, 95% CI 1.33-1.62, p <0.01). The incidence of distant metastases in 
      men 75 years old or older reached a nadir in 2011 compared to 2004 (IR 0.81, 95% 
      CI 0.74-0.90, p <0.01) and it increased in 2012 compared to 2011 (IR 1.13, 95% CI
      1.02-1.24, p <0.05). The risk of cancer specific mortality significantly
      increased in men diagnosed with pelvic lymph node metastases (HR 4.5, 95% CI
      4.2-4.9, p <0.01) and distant metastases (HR 21.9, 95% CI 21.2-22.7, p <0.01)
      compared to men with nonmetastatic disease. CONCLUSIONS: The incidence of pelvic 
      lymph node metastases is increasing coincident with a decline in the detection of
      localized disease. Whether this portends an increase in the burden of advanced
      disease or simply reflects decreased lead time remains unclear. However, this
      should be monitored closely as the increase in N1 disease reflects an increase in
      incurable prostate cancer at diagnosis.
CI  - Copyright (c) 2018 American Urological Association Education and Research, Inc.
      Published by Elsevier Inc. All rights reserved.
FAU - Bernstein, Adrien N
AU  - Bernstein AN
AD  - Department of Urology, New York Presbyterian Hospital, Weill Cornell Medical
      College, New York, New York.
FAU - Shoag, Jonathan E
AU  - Shoag JE
AD  - Department of Urology, New York Presbyterian Hospital, Weill Cornell Medical
      College, New York, New York.
FAU - Golan, Ron
AU  - Golan R
AD  - Department of Urology, New York Presbyterian Hospital, Weill Cornell Medical
      College, New York, New York.
FAU - Halpern, Joshua A
AU  - Halpern JA
AD  - Department of Urology, New York Presbyterian Hospital, Weill Cornell Medical
      College, New York, New York.
FAU - Schaeffer, Edward M
AU  - Schaeffer EM
AD  - Department of Urology, Northwestern University Feinberg School of Medicine,
      Chicago, Illinois.
FAU - Hsu, Wei-Chun
AU  - Hsu WC
AD  - Department of Healthcare Policy and Research, Weill Cornell Medical College, New 
      York, New York.
FAU - Nguyen, Paul L
AU  - Nguyen PL
AD  - Department of Radiation Oncology, Dana-Farber Cancer Institute, Harvard Medical
      School, Boston, Massachusetts.
FAU - Sedrakyan, Art
AU  - Sedrakyan A
AD  - Department of Healthcare Policy and Research, Weill Cornell Medical College, New 
      York, New York.
FAU - Chen, Ronald C
AU  - Chen RC
AD  - Department of Radiation Oncology, University of North Carolina, Chapel Hill,
      North Carolina.
FAU - Eggener, Scott E
AU  - Eggener SE
AD  - Division of Urology, University of Chicago Medicine, Chicago, Illinois.
FAU - Hu, Jim C
AU  - Hu JC
AD  - Department of Urology, New York Presbyterian Hospital, Weill Cornell Medical
      College, New York, New York. Electronic address: [email protected]
LA  - eng
PT  - Journal Article
DEP - 20171226
PL  - United States
TA  - J Urol
JT  - The Journal of urology
JID - 0376374
OTO - NOTNLM
OT  - SEER Program
OT  - mortality
OT  - neoplasm metastasis
OT  - practice guidelines as topic
OT  - prostatic neoplasms
EDAT- 2017/12/31 06:00
MHDA- 2017/12/31 06:00
CRDT- 2017/12/31 06:00
PHST- 2017/12/16 00:00 [accepted]
PHST- 2017/12/31 06:00 [pubmed]
PHST- 2017/12/31 06:00 [medline]
PHST- 2017/12/31 06:00 [entrez]
AID - S0022-5347(17)78181-5 [pii]
AID - 10.1016/j.juro.2017.12.048 [doi]
PST - aheadofprint
SO  - J Urol. 2017 Dec 26. pii: S0022-5347(17)78181-5. doi: 10.1016/j.juro.2017.12.048.