The importance of lymph node location, burden and treatment outcome in metastatic (M1) Hormone-Sensitive Prostate Cancer (HSPC): Analysis from the STAMPEDE trial Arms A and C
BAUS ePoster online library. Haran Á. 11/10/20; 304213; P10-12
Ms. Á Haran
Ms. Á Haran
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The importance of lymph node location, burden and treatment outcome in metastatic (M1) Hormone-Sensitive Prostate Cancer (HSPC): Analysis from the STAMPEDE trial Arms A and C

Haran Á1,2, Ali A2, Hambrock T3, Hoyle A1,2, Jain Y3, Brawley C4, Amos C4, Calvert J4, Attard G5, Douis H6, Parmar M4, James N7, Sydes M4, Clarke N1,2
1Department of Urology, The Christie and Salford Royal NHS Foundation Trusts, Manchester, 2Genito-urinary Cancer Research Group, Division of Cancer Sciences, The University of Manchester, , 3Department of Radiology, The Christie NHS Foundation Trust, Manchester, 4MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London, 5UCL Cancer Institute, London, 6Department of Radiology, University Hospitals Birmingham NHS Foundation Trust, , 7Royal Marsden Hospital and Institute of Cancer Research, London,

Introduction:
Current metastatic burden definitions, which are critical to treatment decision making, don't account for lymph node metastasis (LNM) location, size or number. Consequently, metastasis directed trials and choice of therapy varies widely. We will report a comprehensive analysis of cross-sectional baseline staging scans, with LNM status, correlated with clinical outcome in metastatic (M1) patients from STAMPEDE to enable appropriate treatment for men with this condition.

Methods:
1086 M1 patients randomised to Arms A or C between October 2005 and March 2013 were eligible. Detailed LNM evaluation was performed using the Royal College of Radiology lymph node diagnostic criteria for cross-sectional imaging (CT/MRI). Scans were reviewed centrally by two experienced readers. LN number and size were annotated in regional (obturator, external iliac, internal iliac and sacral) and non-regional (common iliac, retroperitoneal, mediastinal) areas. Findings were correlated with long-term clinical outcome after treatment.

Results:
LNM distribution was evaluable for 629 men (median age 66, median PSA 115 ng/ml): 307 had lymphadenopathy. Of these, 178 had non-regional LNM (median node number 4, median maximum size 2.1 cm (range 1 to 8.1) and minimum size 1.2 cm (range 0.9 to 3.9). Following regional assessment, obturator LN disease was the most common (203 men), followed by internal (133) and external iliac (117) nodes. For non-regional LNM, 87 patients had both common iliac and retroperitoneal LN disease.

Conclusion:
The data linked to STAMPEDE's treatment outcome will refine existing metastatic burden criteria, thereby improving treatment decision making in men with M1 prostate cancer.
The importance of lymph node location, burden and treatment outcome in metastatic (M1) Hormone-Sensitive Prostate Cancer (HSPC): Analysis from the STAMPEDE trial Arms A and C

Haran Á1,2, Ali A2, Hambrock T3, Hoyle A1,2, Jain Y3, Brawley C4, Amos C4, Calvert J4, Attard G5, Douis H6, Parmar M4, James N7, Sydes M4, Clarke N1,2
1Department of Urology, The Christie and Salford Royal NHS Foundation Trusts, Manchester, 2Genito-urinary Cancer Research Group, Division of Cancer Sciences, The University of Manchester, , 3Department of Radiology, The Christie NHS Foundation Trust, Manchester, 4MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London, 5UCL Cancer Institute, London, 6Department of Radiology, University Hospitals Birmingham NHS Foundation Trust, , 7Royal Marsden Hospital and Institute of Cancer Research, London,

Introduction:
Current metastatic burden definitions, which are critical to treatment decision making, don't account for lymph node metastasis (LNM) location, size or number. Consequently, metastasis directed trials and choice of therapy varies widely. We will report a comprehensive analysis of cross-sectional baseline staging scans, with LNM status, correlated with clinical outcome in metastatic (M1) patients from STAMPEDE to enable appropriate treatment for men with this condition.

Methods:
1086 M1 patients randomised to Arms A or C between October 2005 and March 2013 were eligible. Detailed LNM evaluation was performed using the Royal College of Radiology lymph node diagnostic criteria for cross-sectional imaging (CT/MRI). Scans were reviewed centrally by two experienced readers. LN number and size were annotated in regional (obturator, external iliac, internal iliac and sacral) and non-regional (common iliac, retroperitoneal, mediastinal) areas. Findings were correlated with long-term clinical outcome after treatment.

Results:
LNM distribution was evaluable for 629 men (median age 66, median PSA 115 ng/ml): 307 had lymphadenopathy. Of these, 178 had non-regional LNM (median node number 4, median maximum size 2.1 cm (range 1 to 8.1) and minimum size 1.2 cm (range 0.9 to 3.9). Following regional assessment, obturator LN disease was the most common (203 men), followed by internal (133) and external iliac (117) nodes. For non-regional LNM, 87 patients had both common iliac and retroperitoneal LN disease.

Conclusion:
The data linked to STAMPEDE's treatment outcome will refine existing metastatic burden criteria, thereby improving treatment decision making in men with M1 prostate cancer.
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