Differences in rates of pelvic lymph node dissection in National Comprehensive Cancer Network favorable, unfavorable intermediate- and high-risk prostate cancer across United States SEER registries
Abstract. Background. The National Comprehensive Cancer Network (NCCN) guidelines recommend pelvic lymph node dissection (PLND) in NCCN high- and intermediate-risk prostate cancer patients. We tested for PLND nonadherence (no-PLND) rates within the Surveillance Epidemiology and End Results (2010–201...
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Health
2022-12-01
|
| Series: | Current Urology |
| Online Access: | http://journals.lww.com/10.1097/CU9.0000000000000132 |
| _version_ | 1828056046610939904 |
|---|---|
| author | Rocco Simone Flammia Benedikt Hoeh Francesco Chierigo Lukas Hohenhorst Gabriele Sorce Zhen Tian Costantino Leonardo Markus Graefen Carlo Terrone Fred Saad Shahrokh F. Shariat Alberto Briganti Francesco Montorsi Felix K. H. Chun Michele Gallucci Pierre I. Karakiewicz |
| author_facet | Rocco Simone Flammia Benedikt Hoeh Francesco Chierigo Lukas Hohenhorst Gabriele Sorce Zhen Tian Costantino Leonardo Markus Graefen Carlo Terrone Fred Saad Shahrokh F. Shariat Alberto Briganti Francesco Montorsi Felix K. H. Chun Michele Gallucci Pierre I. Karakiewicz |
| author_sort | Rocco Simone Flammia |
| collection | DOAJ |
| description | Abstract. Background. The National Comprehensive Cancer Network (NCCN) guidelines recommend pelvic lymph node dissection (PLND) in NCCN high- and intermediate-risk prostate cancer patients. We tested for PLND nonadherence (no-PLND) rates within the Surveillance Epidemiology and End Results (2010–2015).
Materials and methods. We identified all radical prostatectomy patients who fulfilled the NCCN PLND guideline criteria (n = 23,495). Nonadherence rates to PLND were tabulated and further stratified according to NCCN risk subgroups, race/ethnicity, geographic distribution, and year of diagnosis.
Results. Overall, the no-PLND rate was 26%; it was 41%, 25%, and 11% in the NCCN intermediate favorable, intermediate unfavorable, and high-risk prostate cancer patients, respectively (p < 0.001). Over time, the no-PLND rates declined in the overall cohort and within each NCCN risk subgroup. Georgia exhibited the highest no-PLND rate (49%), whereas New Jersey exhibited the lowest (15%). Finally, no-PLND race/ethnicity differences were recorded only in the NCCN intermediate unfavorable subgroup, where Asians exhibited the lowest no-PLND rate (20%) versus African Americans (27%) versus Whites (26%) versus Hispanic-Latinos (25%).
Conclusions. The lowest no-PLND rates were recorded in the NCCN high-risk patients followed by NCCN intermediate unfavorable and favorable risk in that order. Our findings suggest that unexpectedly elevated differences in no-PLND rates warrant further examination. In all the NCCN risk subgroups, the no-PLND rates decreased over time. |
| first_indexed | 2024-04-10T20:48:16Z |
| format | Article |
| id | doaj.art-a56c9b8e0d404091b331323e993e7f0f |
| institution | Directory Open Access Journal |
| issn | 1661-7649 |
| language | English |
| last_indexed | 2024-04-10T20:48:16Z |
| publishDate | 2022-12-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Current Urology |
| spelling | doaj.art-a56c9b8e0d404091b331323e993e7f0f2023-01-24T00:57:27ZengWolters Kluwer HealthCurrent Urology1661-76492022-12-0116419119610.1097/CU9.0000000000000132202212000-00001Differences in rates of pelvic lymph node dissection in National Comprehensive Cancer Network favorable, unfavorable intermediate- and high-risk prostate cancer across United States SEER registriesRocco Simone Flammia0Benedikt Hoeh1Francesco Chierigo2Lukas Hohenhorst3Gabriele Sorce4Zhen Tian5Costantino Leonardo6Markus Graefen7Carlo Terrone8Fred Saad9Shahrokh F. Shariat10Alberto Briganti11Francesco Montorsi12Felix K. H. Chun13Michele Gallucci14Pierre I. Karakiewicz15a Department of Maternal-Child and Urological Sciences, Sapienza University Rome, Policlinico Umberto I Hospital, Rome, Italyb Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Quebec, Canadab Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Quebec, Canadab Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Quebec, Canadab Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Quebec, Canadab Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Quebec, Canadaa Department of Maternal-Child and Urological Sciences, Sapienza University Rome, Policlinico Umberto I Hospital, Rome, Italye Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germanyd IRCCS Ospedale Policlinico San Martino, Genova, Italyb Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Quebec, Canadah Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austriag Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italyg Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italyc Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germanya Department of Maternal-Child and Urological Sciences, Sapienza University Rome, Policlinico Umberto I Hospital, Rome, Italyb Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Quebec, CanadaAbstract. Background. The National Comprehensive Cancer Network (NCCN) guidelines recommend pelvic lymph node dissection (PLND) in NCCN high- and intermediate-risk prostate cancer patients. We tested for PLND nonadherence (no-PLND) rates within the Surveillance Epidemiology and End Results (2010–2015). Materials and methods. We identified all radical prostatectomy patients who fulfilled the NCCN PLND guideline criteria (n = 23,495). Nonadherence rates to PLND were tabulated and further stratified according to NCCN risk subgroups, race/ethnicity, geographic distribution, and year of diagnosis. Results. Overall, the no-PLND rate was 26%; it was 41%, 25%, and 11% in the NCCN intermediate favorable, intermediate unfavorable, and high-risk prostate cancer patients, respectively (p < 0.001). Over time, the no-PLND rates declined in the overall cohort and within each NCCN risk subgroup. Georgia exhibited the highest no-PLND rate (49%), whereas New Jersey exhibited the lowest (15%). Finally, no-PLND race/ethnicity differences were recorded only in the NCCN intermediate unfavorable subgroup, where Asians exhibited the lowest no-PLND rate (20%) versus African Americans (27%) versus Whites (26%) versus Hispanic-Latinos (25%). Conclusions. The lowest no-PLND rates were recorded in the NCCN high-risk patients followed by NCCN intermediate unfavorable and favorable risk in that order. Our findings suggest that unexpectedly elevated differences in no-PLND rates warrant further examination. In all the NCCN risk subgroups, the no-PLND rates decreased over time.http://journals.lww.com/10.1097/CU9.0000000000000132 |
| spellingShingle | Rocco Simone Flammia Benedikt Hoeh Francesco Chierigo Lukas Hohenhorst Gabriele Sorce Zhen Tian Costantino Leonardo Markus Graefen Carlo Terrone Fred Saad Shahrokh F. Shariat Alberto Briganti Francesco Montorsi Felix K. H. Chun Michele Gallucci Pierre I. Karakiewicz Differences in rates of pelvic lymph node dissection in National Comprehensive Cancer Network favorable, unfavorable intermediate- and high-risk prostate cancer across United States SEER registries Current Urology |
| title | Differences in rates of pelvic lymph node dissection in National Comprehensive Cancer Network favorable, unfavorable intermediate- and high-risk prostate cancer across United States SEER registries |
| title_full | Differences in rates of pelvic lymph node dissection in National Comprehensive Cancer Network favorable, unfavorable intermediate- and high-risk prostate cancer across United States SEER registries |
| title_fullStr | Differences in rates of pelvic lymph node dissection in National Comprehensive Cancer Network favorable, unfavorable intermediate- and high-risk prostate cancer across United States SEER registries |
| title_full_unstemmed | Differences in rates of pelvic lymph node dissection in National Comprehensive Cancer Network favorable, unfavorable intermediate- and high-risk prostate cancer across United States SEER registries |
| title_short | Differences in rates of pelvic lymph node dissection in National Comprehensive Cancer Network favorable, unfavorable intermediate- and high-risk prostate cancer across United States SEER registries |
| title_sort | differences in rates of pelvic lymph node dissection in national comprehensive cancer network favorable unfavorable intermediate and high risk prostate cancer across united states seer registries |
| url | http://journals.lww.com/10.1097/CU9.0000000000000132 |
| work_keys_str_mv | AT roccosimoneflammia differencesinratesofpelviclymphnodedissectioninnationalcomprehensivecancernetworkfavorableunfavorableintermediateandhighriskprostatecanceracrossunitedstatesseerregistries AT benedikthoeh differencesinratesofpelviclymphnodedissectioninnationalcomprehensivecancernetworkfavorableunfavorableintermediateandhighriskprostatecanceracrossunitedstatesseerregistries AT francescochierigo differencesinratesofpelviclymphnodedissectioninnationalcomprehensivecancernetworkfavorableunfavorableintermediateandhighriskprostatecanceracrossunitedstatesseerregistries AT lukashohenhorst differencesinratesofpelviclymphnodedissectioninnationalcomprehensivecancernetworkfavorableunfavorableintermediateandhighriskprostatecanceracrossunitedstatesseerregistries AT gabrielesorce differencesinratesofpelviclymphnodedissectioninnationalcomprehensivecancernetworkfavorableunfavorableintermediateandhighriskprostatecanceracrossunitedstatesseerregistries AT zhentian differencesinratesofpelviclymphnodedissectioninnationalcomprehensivecancernetworkfavorableunfavorableintermediateandhighriskprostatecanceracrossunitedstatesseerregistries AT costantinoleonardo differencesinratesofpelviclymphnodedissectioninnationalcomprehensivecancernetworkfavorableunfavorableintermediateandhighriskprostatecanceracrossunitedstatesseerregistries AT markusgraefen differencesinratesofpelviclymphnodedissectioninnationalcomprehensivecancernetworkfavorableunfavorableintermediateandhighriskprostatecanceracrossunitedstatesseerregistries AT carloterrone differencesinratesofpelviclymphnodedissectioninnationalcomprehensivecancernetworkfavorableunfavorableintermediateandhighriskprostatecanceracrossunitedstatesseerregistries AT fredsaad differencesinratesofpelviclymphnodedissectioninnationalcomprehensivecancernetworkfavorableunfavorableintermediateandhighriskprostatecanceracrossunitedstatesseerregistries AT shahrokhfshariat differencesinratesofpelviclymphnodedissectioninnationalcomprehensivecancernetworkfavorableunfavorableintermediateandhighriskprostatecanceracrossunitedstatesseerregistries AT albertobriganti differencesinratesofpelviclymphnodedissectioninnationalcomprehensivecancernetworkfavorableunfavorableintermediateandhighriskprostatecanceracrossunitedstatesseerregistries AT francescomontorsi differencesinratesofpelviclymphnodedissectioninnationalcomprehensivecancernetworkfavorableunfavorableintermediateandhighriskprostatecanceracrossunitedstatesseerregistries AT felixkhchun differencesinratesofpelviclymphnodedissectioninnationalcomprehensivecancernetworkfavorableunfavorableintermediateandhighriskprostatecanceracrossunitedstatesseerregistries AT michelegallucci differencesinratesofpelviclymphnodedissectioninnationalcomprehensivecancernetworkfavorableunfavorableintermediateandhighriskprostatecanceracrossunitedstatesseerregistries AT pierreikarakiewicz differencesinratesofpelviclymphnodedissectioninnationalcomprehensivecancernetworkfavorableunfavorableintermediateandhighriskprostatecanceracrossunitedstatesseerregistries |