We investigated the association between lymph node yield (LNY) with overall survival (OS) and post-radical prostatectomy (RP) secondary treatments among men with pathologically node negative (pN0) prostate cancer. We reviewed the National Cancer Database for men with Gleason Grade Group 2 or higher prostate cancer treated with RP and had pathologically node-negative disease. LNY was modeled as a continuous and categorical variable grouped by quartiles of LNY. Secondary treatment was defined as the use of radiation or systemic therapy post-RP. Multivariable Cox proportional hazards and logistic regression models were used to test for an association of LNY with OS and secondary treatments, respectively. We identified 89,416 men with pN0 prostate cancer treated with RP from 2010-2015. LNY was associated with improved OS when modeled as a categorical and continuous variable. The third (6-9 nodes) and fourth (≥10 nodes) quartiles of LNY were associated with improved OS (HR 0.87, 95% CI 0.79-0.96, P = 0.006 and HR 0.88, 95% CI 0.79-0.98, P= 0.017, respectively) when compared with the lowest quartile of LNY (≤3 nodes) and the hazard of death decreased by 1% for each benign lymph node removed (HR 0.99, 95% CI 0.98-0.99, P= 0.022). Additionally, categorical and continuous LNY was associated with significantly less use of post-RP secondary treatments. Removal of additional negative lymph nodes was associated with improved OS and less secondary treatments in patients with pN0 prostate cancer. These data suggest that removing a higher quantity of lymph nodes provides more accurate staging and prognosis.

我们调查了病理淋巴结阴性 (pN0) 前列腺癌男性的淋巴结产量 (LNY) 与总生存期 (OS) 和根治性前列腺切除术 (RP) 二次治疗之间的关系。我们回顾了国家癌症数据库中 Gleason 2 级或更高级别前列腺癌患者接受 RP 治疗且病理淋巴结阴性的男性。LNY 被建模为按 LNY 的四分位数分组的连续和分类变量。二级治疗被定义为在 RP 后使用放射或全身治疗。多变量 Cox 比例风险和逻辑回归模型分别用于测试 LNY 与 OS 和二级治疗的关联。我们确定了 2010-2015 年间接受 RP 治疗的 89,416 名 pN0 前列腺癌男性。当建模为分类变量和连续变量时，LNY 与改进的 OS 相关。LNY 的第三（6-9 个节点）和第四个（≥10 个节点）四分位数与改善 OS 相关（HR 0.87，95% CI 0.79-0.96，P  = 0.006 和 HR 0.88，95% CI 0.79-0.98，P = 0.017，分别与 LNY 的最低四分位数（≤3 个淋巴结）相比，每切除一个良性淋巴结，死亡风险降低 1%（HR 0.99, 95% CI 0.98-0.99, P = 0.022)。此外，分类和连续 LNY 与 RP 后二级治疗的使用显着减少有关。去除额外的阴性淋巴结与 pN0 前列腺癌患者的 OS 改善和二次治疗减少有关。这些数据表明，切除更多的淋巴结可提供更准确的分期和预后。