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Sandy Srinivas, MD
Sandy Srinivas, MD
Posted: Friday, February 10, 2023
Findings presented in BMC Urology suggest that lymph node degeneration may be associated with nodal metastatic pattern in some patients with prostate cancer. Risk of tumor cell infiltration and metastasis for a given lymph node appears to be strongly associated with that node’s degree of degeneration.
“This, in addition to multidirectional lymphatic drainage, is an additional explanation for the occurrence of skip metastases in prostate cancer, resulting in an unpredictable metastasis pattern,” concluded Daniel Gödde, MD, of Witten/Herdecke University, Wuppertal, Germany, and colleagues.
The retrospective analysis included 6,026 lymph node specimens originating from 390 prostatectomies performed in 2011. Overall, 81 lymph nodes harbored metastases. A total of 5,173 nodes, including all with metastases, were evaluable via complete cross-section analysis. More than half (63.0%) of lymph nodes measuring more than 10 mm in diameter contained metastases. Metastases were primarily found in higher-functioning lymph nodes. Low lipomatous atrophy was more common among metastatic nodes (84.0% vs. 66.7%). Degenerative conditions such as capsular fibrosis, calcifications, and framework fibrosis occurred less frequently in metastatic nodes than nonmetastatic nodes (14.8% vs. 35.4%, 35.8% vs. 46.1%, and 69.8% vs. 75.3%, respectively).
Median patient age was 68 years. A total of 15 patients harbored a single lymph node metastasis, whereas 20 patients had from two to six lymph nodes containing metastasis. The primary location of lymph nodes with metastases was the obturator fossa region of the pelvis, although metastases were identified across all pelvic anatomic regions. Between 1% and 90% of included metastases ranged from 0.5 to 18 mm in diameter.
Disclosure: The study authors reported no conflicts of interest.
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