Body Mass Index and prostatic specific antigen are independent predictors of multiple prostate cancer lymph node metastases in Caucasian patients undergoing robot assisted radical prostatectomy and extended pelvic lymph node dissection.

Abstract

BACKGROUND\nTo investigate the risk factors contributing to multiple lymph node invasion (LNI) in patients with prostate cancer (PCa) undergoing extended pelvic lymph node dissection (ePLND) during robot assisted radical prostatectomy (RARP).\n\n\nMETHODS\n211 patients who underwent RARP and ePNLD from June 2013 to March 2017 were classified according to lymph node status in the surgical specimen (absent, single or multiple). Risk factors of LNI were evaluated by the multinomial logistic regression model. A receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to assess the efficacy of factors and model evaluation.\n\n\nRESULTS\nOn multivariate analysis, the risk of multiple LNI, was independently increased by BMI (odds ratio, OR = 1.194; P = 0.026) and PSA (OR = 1.089; P = 0.014) when compared to patients without LNI. ROC curves indicated that both BMI (AUC = 0.702) and PSA (AUC = 0.732) had fair discrimination power. For each unit of increase in PSA, the odds of multiple lymph node invasion increased by 8.9% and for each unit increase of BMI, the odds of multiple LNI increased by 19.4%.\n\n\nCONCLUSIONS\nThe risk of multiple LNI was independently predicted by PSA and BMI with fair discrimination power.