Lymph Node Involvement Using Extended Pelvic Lymphadenectomy in Clinically Localized Prostate Cancer

Prostatic Neoplasms Clinical Trial

— LNIEPLCLPC  

Official title:

Lymph Node Involvement Using Extended Pelvic Lymphadenectomy in Clinically Localized Prostate Cancer in Bogota Colombia.

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02156414
• Other study ID #: 7-2013
• Status: Completed
• Phase: N/A
• First received: May 13, 2014
• Last updated: April 21, 2015
• Start date: March 2013
• Est. completion date: August 2014

Study information

• Verified date: April 2015
• Source: Javeriana University
• Contact: n/a
• Is FDA regulated: No
• Health authority: Colombia: Ethics Committee
• Study type: Observational [Patient Registry]

Clinical Trial Summary

Prostate cancer is considered the fourth most common malignancy cancer in America. However, in Colombia the incidence is higher, and it is considered the second cause of death among men for malignance diseases. In the framework of clinical localized prostate cancer there is a controversy regarding the best predictors of risk and the best treatment options. The actual literature is discussing the possibility of underestimate the disease and actual tools are not sufficient for proper characterization. Is in this context that extended pelvic lymphadenectomy emerges as a stratification tool in prostate cancer that defines the real commitment of the disease. The investigators need to know the characteristics that the disease has on the investigators community so the investigators can generate appropriate therapeutic approach. Thus, the present prospective observational-descriptive multicenter study, want to determine in three referral centers in Bogotá Colombia , the frequency of pelvic node involvement in patients with localized clinical prostate cancer from the stratification achieved by pelvic lymphadenectomy extended.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 135
• Est. completion date: August 2014
• Est. primary completion date: August 2014
• Accepts healthy volunteers: No
• Gender: Male
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Patients with clinical localized prostate cancer

• Clinical stage: cT1-cT2-, N0-Nx, M0-Mx

• Patients who undergo radical prostatectomy and extended lymphadenectomy in one of the 3 centers of reference.

Exclusion Criteria:

• Patients in which the standard technique of the extended lymphadenectomy could not be done and it was changed.

Study Design

Observational Model: Cohort, Time Perspective: Prospective

Related Conditions & MeSH terms

• Lymphoma
• Neoplasms
• Neoplasms, Second Primary
• Prostatic Neoplasms
• Secondary Malignant Neoplasm of Lymph Node

Intervention

Procedure:
• Radical Prostatectomy
Radical Prostatectomy
• Extended Lymphadenectomy
Extended Lymphadenectomy

Locations

Country	Name	City	State
Colombia	Fundacion Cardioinfantil	Bogota
Colombia	Fundacion Hospital Santafe	Bogota
Colombia	Hospital Universitario San Ignacio	Bogota

Sponsors (4)

Lead Sponsor	Collaborator
Javeriana University	Fundación Cardioinfantil Instituto de Cardiología, Fundación Santa Fe de Bogota, Hospital Universitario San Ignacio

Country where clinical trial is conducted

Colombia, 

References & Publications (27)

Abdollah F, Sun M, Briganti A, Thuret R, Schmitges J, Gallina A, Suardi N, Capitanio U, Salonia A, Shariat SF, Perrotte P, Rigatti P, Montorsi F, Karakiewicz PI. Critical assessment of the European Association of Urology guideline indications for pelvic lymph node dissection at radical prostatectomy. BJU Int. 2011 Dec;108(11):1769-75. doi: 10.1111/j.1464-410X.2011.10204.x. Epub 2011 Apr 20. — View Citation

Abdollah F, Sun M, Suardi N, Gallina A, Capitanio U, Bianchi M, Tutolo M, Passoni N, Karakiewicz PI, Rigatti P, Montorsi F, Briganti A; National Comprehensive Cancer Network. National Comprehensive Cancer Network practice guidelines 2011: Need for more accurate recommendations for pelvic lymph node dissection in prostate cancer. J Urol. 2012 Aug;188(2):423-8. doi: 10.1016/j.juro.2012.03.129. Epub 2012 Jun 13. — View Citation

Abdollah F, Sun M, Thuret R, Budäus L, Jeldres C, Graefen M, Briganti A, Perrotte P, Rigatti P, Montorsi F, Karakiewicz PI. Decreasing rate and extent of lymph node staging in patients undergoing radical prostatectomy may undermine the rate of diagnosis of lymph node metastases in prostate cancer. Eur Urol. 2010 Dec;58(6):882-92. doi: 10.1016/j.eururo.2010.09.029. Epub 2010 Sep 28. — View Citation

Allaf ME, Palapattu GS, Trock BJ, Carter HB, Walsh PC. Anatomical extent of lymph node dissection: impact on men with clinically localized prostate cancer. J Urol. 2004 Nov;172(5 Pt 1):1840-4. — View Citation

Bader P, Burkhard FC, Markwalder R, Studer UE. Disease progression and survival of patients with positive lymph nodes after radical prostatectomy. Is there a chance of cure? J Urol. 2003 Mar;169(3):849-54. — View Citation

Bhatta-Dhar N, Reuther AM, Zippe C, Klein EA. No difference in six-year biochemical failure rates with or without pelvic lymph node dissection during radical prostatectomy in low-risk patients with localized prostate cancer. Urology. 2004 Mar;63(3):528-31. Review. — View Citation

Boyle P, Ferlay J. Cancer incidence and mortality in Europe, 2004. Ann Oncol. 2005 Mar;16(3):481-8. Epub 2005 Feb 17. — View Citation

Brawley OW. Prostate cancer epidemiology in the United States. World J Urol. 2012 Apr;30(2):195-200. doi: 10.1007/s00345-012-0824-2. Epub 2012 Apr 5. Review. — View Citation

Briganti A, Blute ML, Eastham JH, Graefen M, Heidenreich A, Karnes JR, Montorsi F, Studer UE. Pelvic lymph node dissection in prostate cancer. Eur Urol. 2009 Jun;55(6):1251-65. doi: 10.1016/j.eururo.2009.03.012. Epub 2009 Mar 10. Review. — View Citation

Briganti A, Chun FK, Salonia A, Gallina A, Zanni G, Scattoni V, Valiquette L, Rigatti P, Montorsi F, Karakiewicz PI. Critical assessment of ideal nodal yield at pelvic lymphadenectomy to accurately diagnose prostate cancer nodal metastasis in patients undergoing radical retropubic prostatectomy. Urology. 2007 Jan;69(1):147-51. — View Citation

Cagiannos I, Karakiewicz P, Eastham JA, Ohori M, Rabbani F, Gerigk C, Reuter V, Graefen M, Hammerer PG, Erbersdobler A, Huland H, Kupelian P, Klein E, Quinn DI, Henshall SM, Grygiel JJ, Sutherland RL, Stricker PD, Morash CG, Scardino PT, Kattan MW. A preoperative nomogram identifying decreased risk of positive pelvic lymph nodes in patients with prostate cancer. J Urol. 2003 Nov;170(5):1798-803. — View Citation

Clark T, Parekh DJ, Cookson MS, Chang SS, Smith ER Jr, Wells N, Smith J Jr. Randomized prospective evaluation of extended versus limited lymph node dissection in patients with clinically localized prostate cancer. J Urol. 2003 Jan;169(1):145-7; discussion 147-8. — View Citation

D'Amico AV, Cote K, Loffredo M, Renshaw AA, Schultz D. Determinants of prostate cancer-specific survival after radiation therapy for patients with clinically localized prostate cancer. J Clin Oncol. 2002 Dec 1;20(23):4567-73. — View Citation

D'Amico AV, Whittington R, Malkowicz SB, Schultz D, Blank K, Broderick GA, Tomaszewski JE, Renshaw AA, Kaplan I, Beard CJ, Wein A. Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA. 1998 Sep 16;280(11):969-74. — View Citation

Delahunt B, Miller RJ, Srigley JR, Evans AJ, Samaratunga H. Gleason grading: past, present and future. Histopathology. 2012 Jan;60(1):75-86. doi: 10.1111/j.1365-2559.2011.04003.x. — View Citation

Epstein JI, Allsbrook WC Jr, Amin MB, Egevad LL; ISUP Grading Committee. The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma. Am J Surg Pathol. 2005 Sep;29(9):1228-42. Review. — View Citation

Gacci M, Del Popolo G, Artibani W, Tubaro A, Palli D, Vittori G, Lapini A, Serni S, Carini M. Visual assessment of uroflowmetry curves: description and interpretation by urodynamists. World J Urol. 2007 Jun;25(3):333-7. Epub 2007 Apr 14. — View Citation

Gerstenbluth RE, Seftel AD, Hampel N, Oefelein MG, Resnick MI. The accuracy of the increased prostate specific antigen level (greater than or equal to 20 ng./ml.) in predicting prostate cancer: is biopsy always required? J Urol. 2002 Nov;168(5):1990-3. — View Citation

Harnden P, Shelley MD, Coles B, Staffurth J, Mason MD. Should the Gleason grading system for prostate cancer be modified to account for high-grade tertiary components? A systematic review and meta-analysis. Lancet Oncol. 2007 May;8(5):411-9. Review. — View Citation

Heidenreich A, Bellmunt J, Bolla M, Joniau S, Mason M, Matveev V, Mottet N, Schmid HP, van der Kwast T, Wiegel T, Zattoni F. [EAU guidelines on prostate cancer. Part I: screening, diagnosis, and treatment of clinically localised disease]. Actas Urol Esp. 2011 Oct;35(9):501-14. doi: 10.1016/j.acuro.2011.04.004. Epub 2011 Jul 14. Spanish. — View Citation

Heidenreich A, Bellmunt J, Bolla M, Joniau S, Mason M, Matveev V, Mottet N, Schmid HP, van der Kwast T, Wiegel T, Zattoni F; European Association of Urology. EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and treatment of clinically localised disease. Eur Urol. 2011 Jan;59(1):61-71. doi: 10.1016/j.eururo.2010.10.039. Epub 2010 Oct 28. — View Citation

Hyndman ME, Mullins JK, Pavlovich CP. Pelvic node dissection in prostate cancer: extended, limited, or not at all? Curr Opin Urol. 2010 May;20(3):211-7. doi: 10.1097/MOU.0b013e328338405d. Review. — View Citation

Miki J, Egawa S. The role of lymph node dissection in the management of prostate cancer. Int J Clin Oncol. 2011 Jun;16(3):195-202. doi: 10.1007/s10147-011-0245-z. Epub 2011 May 10. Review. — View Citation

Mohler J, Bahnson RR, Boston B, Busby JE, D'Amico A, Eastham JA, Enke CA, George D, Horwitz EM, Huben RP, Kantoff P, Kawachi M, Kuettel M, Lange PH, Macvicar G, Plimack ER, Pow-Sang JM, Roach M 3rd, Rohren E, Roth BJ, Shrieve DC, Smith MR, Srinivas S, Twardowski P, Walsh PC. NCCN clinical practice guidelines in oncology: prostate cancer. J Natl Compr Canc Netw. 2010 Feb;8(2):162-200. — View Citation

Moyer VA; U.S. Preventive Services Task Force. Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2012 Jul 17;157(2):120-34. doi: 10.7326/0003-4819-157-2-201207170-00459. — View Citation

Thompson I, Thrasher JB, Aus G, Burnett AL, Canby-Hagino ED, Cookson MS, D'Amico AV, Dmochowski RR, Eton DT, Forman JD, Goldenberg SL, Hernandez J, Higano CS, Kraus SR, Moul JW, Tangen CM; AUA Prostate Cancer Clinical Guideline Update Panel. Guideline for the management of clinically localized prostate cancer: 2007 update. J Urol. 2007 Jun;177(6):2106-31. — View Citation

Wagner M, Sokoloff M, Daneshmand S. The role of pelvic lymphadenectomy for prostate cancer--therapeutic? J Urol. 2008 Feb;179(2):408-13. Review. — View Citation

* Note: There are 27 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Lymph Node Involvement Using Extended Pelvic Lymphadenectomy by histopathology analysis	After extended pelvic lymphadenectomy the nodes are classified in ilio-obturator nodes and internal iliaca nodes. Then those nodes are send to the pathology department of the each center, and by the histopathology analysis, the pathologist determine which nodes are compromised. With the histopathology result, the investigators report de nodal involvement.	within the first 30 days after surgery	Yes
Secondary	The Histopathology substaging Gleason score in the surgery piece vs Biopsy report before surgery.	After radical prostatectomy the specimen (prostate) is send to the pathology department of each center, and by the histopathology analysis, the pathologist determine the gleason score. Then the investigators compare this result to the one achieved in the biopsy result, and determine if there was a oncologic substaging related to the gleason score.	Within the first 30 days after surgery	Yes

External Links

•   UROLOGY DEPARTMENT JAVERIANA UNIVERSITY