Does the Number of Lymph Nodes Removed During Radical Prostatectomy Impact Risk of Biochemical Recurrence in Patients With Isolated Seminal Vesicle Invasion?
Bibliographic record
Abstract
Objectives: To determine if greater lymph node yield (LNY) during radical prostatectomy is associated with improved biochemical recurrence for men with prostate cancer and isolated seminal vesicle invasion (SVI).Previous studies have shown that total number of lymph nodes removed at RP results in improved survival, regardless of node positivity, but this has not been examined in men with isolated SVI.Methods: The IRB-approved Columbia University Urologic Oncology Database was reviewed to identify patients who underwent RP from 1990-2011 and had prostate cancer with isolated SVI (i.e.pT3bN0Mx).BCR was defined as two postoperative PSA values >0.2 ng/mL.Cox proportional hazards model was used to determine if LNY (continuous) was predictive of BCR, when controlling for clinical and pathologic features.Results: We identified 155 patients with isolated SVI.At a mean follow-up of 48 months, 96 patients (62.5%) experienced BCR.Estimated 5-year freedom from BCR rate was 45%.Mean number of LNs removed was 8.9 (1-35).Using the Cox proportional Hazards model, continuous LNY was not significantly associated with risk of BCR (p=0.25), while PSA (HR 2.3, p=0.01), pathologic Gleason score (p=0.023), and bladder neck invasion (p=0.04) were significant.Conclusion: Seminal vesicle invasion after radical prostatectomy is associated with a high risk of BCR, even in the absence of positive surgical margins or lymphatic involvement.Our study demonstrates that the lymph node yield at the time of prostatectomy does not affect the risk of BCR in men with node-negative SVI.Further studies are warranted to evaluate cancer-specific and overall survival.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".