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Therapeutic Value of Standard Versus Extended Pelvic Lymph Node Dissection During Radical Prostatectomy for High-Risk Prostate Cancer

  • Prostate Cancer (S Prasad, Section Editor)
  • Published:
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Abstract

Extent of pelvic lymph node dissection (PLND) during radical prostatectomy (RP) remains a subject of debate. Here, we review the literature covering the value of extended PLND (ePLND) during RP for high-risk prostate cancer (PCa) over a standard PLND, with a focus on potential therapeutic advantage. PLND may provide valuable prognostic information to high-risk PCa patients, and incorporating the common iliac and presacral nodes to ePLND templates further improves pathologic nodal staging accuracy. Although increased PLND extent is associated with increased lymphocele/lymphedema rates, it is not associated with increased venous thromboembolism rates. The therapeutic role of ePLND remains uncertain. While recent retrospective studies suggest an increased number of nodes removed within the ePLND template are associated with improved survival outcomes, such retrospective studies cannot completely adjust for the Will Rodgers phenomenon or surgeon-specific factors. Thus, the results of randomized trials are eagerly awaited in this arena.

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Acknowledgements

The authors thank Francesca Dallago for drawing the figure depicting anatomical regions of lymph node dissections.

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Authors and Affiliations

  1. Department of Urology, Mayo Clinic Rochester, Rochester, MN, USA

    Michele Colicchia, Vidit Sharma & R. Jeffrey Karnes

  2. Center for Outcomes Research Analytics and Evaluation, Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI, USA

    Firas Abdollah

  3. Division of Oncology/Unit of Urology, Urological Research Institute, San Raffaele Scientific Institute, Milan, Italy

    Alberto Briganti

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  1. Michele Colicchia
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Correspondence to R. Jeffrey Karnes.

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Michele Colicchia, Vidit Sharma, Firas Abdollah, Alberto Briganti, and R. Jeffrey Karnes each declare no potential conflicts of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Prostate Cancer

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Colicchia, M., Sharma, V., Abdollah, F. et al. Therapeutic Value of Standard Versus Extended Pelvic Lymph Node Dissection During Radical Prostatectomy for High-Risk Prostate Cancer. Curr Urol Rep 18, 51 (2017). https://doi.org/10.1007/s11934-017-0696-5

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  • DOI: https://doi.org/10.1007/s11934-017-0696-5

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