Influence of lymph node degeneration on metastases in prostate cancer: or why we must look for a needle in a haystack
Abstract Background To evaluate the incidence of lymph node degeneration and its association with nodal metastatic pattern in prostate cancer. Methods A retrospective analysis of the submitted lymph node specimen of 390 prostatectomies in 2011 was performed. All lymph nodes were histologically re-ev...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-01-01
|
| Series: | BMC Urology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12894-022-01167-5 |
| _version_ | 1828069436955820032 |
|---|---|
| author | Daniel Gödde Stephan Degener Christine Walles Rosalie Keller Nici Markus Dreger Katharina Graf Friedrich-Carl von Rundstedt Hans Michael Kvasnicka Susanne Krege Stephan Störkel |
| author_facet | Daniel Gödde Stephan Degener Christine Walles Rosalie Keller Nici Markus Dreger Katharina Graf Friedrich-Carl von Rundstedt Hans Michael Kvasnicka Susanne Krege Stephan Störkel |
| author_sort | Daniel Gödde |
| collection | DOAJ |
| description | Abstract Background To evaluate the incidence of lymph node degeneration and its association with nodal metastatic pattern in prostate cancer. Methods A retrospective analysis of the submitted lymph node specimen of 390 prostatectomies in 2011 was performed. All lymph nodes were histologically re-evaluated and the degree of lymph node degeneration e.g. lipomatous atrophy, capsular and framework fibrosis, and calcifications as well as the lymph node size were recorded. Lymph node degeneration was compared in the anatomic regions of the pelvis as well as in lymph nodes with and without metastases of prostatic cancer. Results Eighty-one of 6026 lymph nodes demonstrated metastases. Complete histologic examination with analysis of a complete cross-section was possible in 5173 lymph nodes including all lymph nodes with metastases. The incidence of lymph node degeneration was different across the various landing sites. Lymph node metastases were primarily detected in less degenerative and therefore more functional lymph nodes. In metastatic versus non-metastatic lymph nodes low lipomatous atrophy was reported in 84.0% versus 66.7% (p = 0.004), capsular fibrosis in 14.8% versus 35.4% (p < 0.001), calcifications in 35.8% versus 46.1% (p = 0.072) and framework fibrosis in 69.8% versus 75.3% (p = 0.53). Metastases were also identified more frequently in larger than in smaller lymph nodes (63.0% vs. 47.5%; p = 0.007). Conclusions Degenerative changes in pelvic lymph nodes are commonly detectable but occur with variable frequency in the various nodal landing sites in the pelvis. The degree of lymph node degeneration of single lymph nodes has a significant influence on whether a lymph node is infiltrated by tumor cells and may harbour metastases. |
| first_indexed | 2024-04-11T00:20:00Z |
| format | Article |
| id | doaj.art-abb8f39c38d54ad58c3daf058815b9f9 |
| institution | Directory Open Access Journal |
| issn | 1471-2490 |
| language | English |
| last_indexed | 2024-04-11T00:20:00Z |
| publishDate | 2023-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Urology |
| spelling | doaj.art-abb8f39c38d54ad58c3daf058815b9f92023-01-08T12:21:46ZengBMCBMC Urology1471-24902023-01-012311610.1186/s12894-022-01167-5Influence of lymph node degeneration on metastases in prostate cancer: or why we must look for a needle in a haystackDaniel Gödde0Stephan Degener1Christine Walles2Rosalie Keller3Nici Markus Dreger4Katharina Graf5Friedrich-Carl von Rundstedt6Hans Michael Kvasnicka7Susanne Krege8Stephan Störkel9Department of Pathology and Molecular Pathology, Helios University Hospital Wuppertal, Witten/Herdecke UniversityDepartment of Urology, Helios University Hospital Wuppertal, Witten/Herdecke UniversityDepartment of Pathology and Molecular Pathology, Helios University Hospital Wuppertal, Witten/Herdecke UniversityClinic for Otolaryngology, Helios Hospital KrefeldDepartment of Urology, Helios University Hospital Wuppertal, Witten/Herdecke UniversityCenter for Clinical Trials, Witten/Herdecke UniversityDepartment of Urology, Helios University Hospital Wuppertal, Witten/Herdecke UniversityDepartment of Pathology and Molecular Pathology, Helios University Hospital Wuppertal, Witten/Herdecke UniversityDepartment of Urology, Evang. Kliniken Essen-MitteDepartment of Pathology and Molecular Pathology, Helios University Hospital Wuppertal, Witten/Herdecke UniversityAbstract Background To evaluate the incidence of lymph node degeneration and its association with nodal metastatic pattern in prostate cancer. Methods A retrospective analysis of the submitted lymph node specimen of 390 prostatectomies in 2011 was performed. All lymph nodes were histologically re-evaluated and the degree of lymph node degeneration e.g. lipomatous atrophy, capsular and framework fibrosis, and calcifications as well as the lymph node size were recorded. Lymph node degeneration was compared in the anatomic regions of the pelvis as well as in lymph nodes with and without metastases of prostatic cancer. Results Eighty-one of 6026 lymph nodes demonstrated metastases. Complete histologic examination with analysis of a complete cross-section was possible in 5173 lymph nodes including all lymph nodes with metastases. The incidence of lymph node degeneration was different across the various landing sites. Lymph node metastases were primarily detected in less degenerative and therefore more functional lymph nodes. In metastatic versus non-metastatic lymph nodes low lipomatous atrophy was reported in 84.0% versus 66.7% (p = 0.004), capsular fibrosis in 14.8% versus 35.4% (p < 0.001), calcifications in 35.8% versus 46.1% (p = 0.072) and framework fibrosis in 69.8% versus 75.3% (p = 0.53). Metastases were also identified more frequently in larger than in smaller lymph nodes (63.0% vs. 47.5%; p = 0.007). Conclusions Degenerative changes in pelvic lymph nodes are commonly detectable but occur with variable frequency in the various nodal landing sites in the pelvis. The degree of lymph node degeneration of single lymph nodes has a significant influence on whether a lymph node is infiltrated by tumor cells and may harbour metastases.https://doi.org/10.1186/s12894-022-01167-5Pelvic lymph nodesDegenerationProstate carcinomaSkip metastasisLymph node dissection |
| spellingShingle | Daniel Gödde Stephan Degener Christine Walles Rosalie Keller Nici Markus Dreger Katharina Graf Friedrich-Carl von Rundstedt Hans Michael Kvasnicka Susanne Krege Stephan Störkel Influence of lymph node degeneration on metastases in prostate cancer: or why we must look for a needle in a haystack BMC Urology Pelvic lymph nodes Degeneration Prostate carcinoma Skip metastasis Lymph node dissection |
| title | Influence of lymph node degeneration on metastases in prostate cancer: or why we must look for a needle in a haystack |
| title_full | Influence of lymph node degeneration on metastases in prostate cancer: or why we must look for a needle in a haystack |
| title_fullStr | Influence of lymph node degeneration on metastases in prostate cancer: or why we must look for a needle in a haystack |
| title_full_unstemmed | Influence of lymph node degeneration on metastases in prostate cancer: or why we must look for a needle in a haystack |
| title_short | Influence of lymph node degeneration on metastases in prostate cancer: or why we must look for a needle in a haystack |
| title_sort | influence of lymph node degeneration on metastases in prostate cancer or why we must look for a needle in a haystack |
| topic | Pelvic lymph nodes Degeneration Prostate carcinoma Skip metastasis Lymph node dissection |
| url | https://doi.org/10.1186/s12894-022-01167-5 |
| work_keys_str_mv | AT danielgodde influenceoflymphnodedegenerationonmetastasesinprostatecancerorwhywemustlookforaneedleinahaystack AT stephandegener influenceoflymphnodedegenerationonmetastasesinprostatecancerorwhywemustlookforaneedleinahaystack AT christinewalles influenceoflymphnodedegenerationonmetastasesinprostatecancerorwhywemustlookforaneedleinahaystack AT rosaliekeller influenceoflymphnodedegenerationonmetastasesinprostatecancerorwhywemustlookforaneedleinahaystack AT nicimarkusdreger influenceoflymphnodedegenerationonmetastasesinprostatecancerorwhywemustlookforaneedleinahaystack AT katharinagraf influenceoflymphnodedegenerationonmetastasesinprostatecancerorwhywemustlookforaneedleinahaystack AT friedrichcarlvonrundstedt influenceoflymphnodedegenerationonmetastasesinprostatecancerorwhywemustlookforaneedleinahaystack AT hansmichaelkvasnicka influenceoflymphnodedegenerationonmetastasesinprostatecancerorwhywemustlookforaneedleinahaystack AT susannekrege influenceoflymphnodedegenerationonmetastasesinprostatecancerorwhywemustlookforaneedleinahaystack AT stephanstorkel influenceoflymphnodedegenerationonmetastasesinprostatecancerorwhywemustlookforaneedleinahaystack |