Retrospective Review of Periurethral Lymph Node Dissection in Clinically Localized Prostate Cancer

Abstract Purpose: The purpose of this study was to evaluate the prevalence of positive periurethral lymph nodes during robotic-assisted radical prostatectomy (RARP) and to investigate the relationship between secondary end points of tumor staging, PSA, and Gleason score. Materials and Methods: This study is a retrospective review of 1177 RARPs performed from October 2011 to February 2022. Using pathology reports, the study population was condensed to 58 patients who had periurethral lymph node tissue. This population was then analyzed for the prevalence of malignant tissue in the specimen. A secondary analysis was performed for data on PSA, Gleason score (preoperative and postoperative), and tumor-nodes-metastases (TNM) staging. Results: Retrospective analysis demonstrated 9 of 58 specimens (15.5%) to be positive for malignancy. There was a statistically significant ( P < .004) correlation between lymph node status and PSA. The average PSA was 17.60 (SD = 15.54) for those with positive periurethral lymph nodes and 7.96 (SD = 6.65) for those with negative periurethral lymph nodes. There was no statistically significant association between lymph node status and preoperative Gleason scores. There was, however, a statistically significant difference across lymph node status and postoperative Gleason scores (X 2 (3) = 11.09, P = .01). Conclusion: Positive periurethral lymph nodes demonstrated higher average PSAs, postoperative Gleason scores, and TNM staging. Further analysis is required to evaluate potential prognostic implications.