Clinical Factors Predicting Bilateral Lymph Node Invasion in High-Risk Prostate Cancer

Background: In high-risk prostate cancer (HR-PCA), it is important to consider the factors associated with extensive lymph node invasion (LNI) before planning treatment methods. Objective: To investigate clinical predictors of bilateral LNI in HR-PCA. Materials and Methods: The study evaluated 261 consecutive patients who underwent radical prostatectomy with extended pelvic lymph node dissection. The multivariate multinomial logistic regression model was computed. Results: The high-risk category included 102 cases. Overall, LNI was detected in 28 patients (27.5%) and was bilateral in 11 cases (10.8%). Independent factors associated with LNI were prostate-specific antigen (PSA) and proportion of positive cores. The main model showed that only higher values of PSA increased the odds of bilateral LNI when compared to patients having unilateral LNI (OR 1.058; p = 0.018). The area under the curve of PSA predicting bilateral LNI was 0.819. Conclusions: In HR-PCA, the independent predictor of LNI was PSA, which varied among patients with bilateral and unilateral LNI.