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Role of anterior prostatic fat pad dissection for extended lymphadenectomy in prostate cancer: a non-randomized study of 100 patients

  • Urology - Original Paper
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Abstract

Purpose

To determine the incidence and significance of lymph nodes found in anterior prostatic fat pad (APFP) and to evaluate the risk factors for the lymph node presence at the APFP according to preoperative and postoperative characteristics during the robot-assisted radical prostatectomy (RARP).

Methods

Between January 2011 and December 2014, 100 consecutive patients (47–77) with clinically localized prostate cancer underwent APFP excision during RARP at a single institute. Extended pelvic lymph node dissection was also performed to moderate- and high-risk patients (86 patients). Preoperative and postoperative findings were recorded, and descriptive analyses and multivariable analyses to predict the presence of lymph node within APFP were performed.

Results

Lymph nodes within APFP were detected in nine (9 %) patients. None of the patients had metastatic lymph node in APFP. Preoperatively, mean PSA levels (14.22 vs. 8.6, p = 0.0001), biopsy Gleason score (p = 0.002) and radical prostatectomy pathology Gleason score (p = 0.001) were higher in patients with lymph nodes at the APFP tissue. Pelvic lymph node metastases were detected in seven of 86 (8 %) patients. Of these seven patients, four (57 %) had lymph nodes at the anterior prostatic fatty pad (p = 0.0001).

Conclusion

APFP dissection must be done regardless of the radical prostatectomy technique chosen. In our opinion, it is not necessary to do pathological examination of the APFP tissue routinely except for the patients with high preoperative PSA values, patients with high prostate biopsy Gleason scores and patients at high risk in order to save time and cost.

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Conflict of interest

The authors report no conflicts of interest.

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Authors and Affiliations

  1. Department of Urology, Faculty of Medicine, Acibadem Bakirkoy and Maslak Hospitals, Acibadem University, Halit Ziya Usakligil Cad. No: 1, 34140, Bakirkoy, Istanbul, Turkey

    Burak Ozkan & Enis Rauf Coskuner

  2. Ethica Hospital, Istanbul, Turkey

    Burcin Tunc

  3. Department of Pathology, Faculty of Medicine, Acibadem Maslak Hospital, Acibadem University, Istanbul, Turkey

    Yesim Saglican

  4. Department of Urology, Acibadem Bakirkoy Hospital, Istanbul, Turkey

    Veli Yalçın

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  1. Burak Ozkan
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  2. Burcin Tunc
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  3. Enis Rauf Coskuner
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  4. Yesim Saglican
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  5. Veli Yalçın
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Correspondence to Burak Ozkan.

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Ozkan, B., Tunc, B., Coskuner, E.R. et al. Role of anterior prostatic fat pad dissection for extended lymphadenectomy in prostate cancer: a non-randomized study of 100 patients. Int Urol Nephrol 47, 959–964 (2015). https://doi.org/10.1007/s11255-015-0982-4

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  • DOI: https://doi.org/10.1007/s11255-015-0982-4

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