Pelvic Lymphadenectomy for High-Risk Prostate Cancer
Pelvic lymphadenectomy is considered the most reliable method of diagnosing lymph node metastases and significant adverse prognostic factor in patients with prostate cancer. In the treatment of prostate cancer, however, the clinical benefit of pelvic lymphadenectomy is debatable. In the past, it was common practice not to conduct radical prostatectomy when the lymph node positive results were seen in the frozen section during surgery . Despite the recent efforts to improve clinical outcomes in patients with prostate cancer, pelvic lymphadenectomy remains controversial. Abdollah et al. recently identified that removing more lymph nodes during radical prostatectomy can significantly improve cancer-specific survival in pN1 patients . Therefore, more comprehensive and accurate nodal staging through extended pelvic lymphadenectomy may indirectly .
- 3.Makarov DV, Trock BJ, Humphreys EB, Mangold LA, Walsh PC, Epstein JI, et al. Updated nomogram to predict pathologic stage of prostate cancer given prostate-specific antigen level, clinical stage, and biopsy Gleason score (Partin tables) based on cases from 2000 to 2005. Urology. 2007;69(6):1095–101.CrossRefPubMedPubMedCentralGoogle Scholar
- 5.Briganti A, Larcher A, Abdollah F, Capitanio U, Gallina A, Suardi N, et al. Updated nomogram predicting lymph node invasion in patients with prostate cancer undergoing extended pelvic lymph node dissection: the essential importance of percentage of positive cores. Eur Urol. 2012;61(3):480–7.CrossRefPubMedGoogle Scholar
- 8.Berglund RK, Sadetsky N, DuChane J, Carroll PR, Klein EA. Limited pelvic lymph node dissection at the time of radical prostatectomy does not affect 5-year failure rates for low, intermediate and high risk prostate cancer: results from CaPSURE. J Urol. 2007;177(2):526–9; discussion 9–30.CrossRefPubMedGoogle Scholar
- 11.Schwerfeld-Bohr J, Kaemper M, Krege S, Heidenreich A. 270 Prospective randomized multicenter study comparing limited vs extended pelvic lymphadenectomy in intermediate and high risk prostate cancer: comparison of complications (SEAL, AUO AP 55/09). Eur Urol Suppl. 2014;13(1):e270.CrossRefGoogle Scholar
- 16.Sanda MG, Chen RC, Crispino T, Freedland S, Greene K, Klotz LH, et al. Clinically localized prostate cancer: AUA/ASTRO/SUO guideline. Part I: risk stratification, shared decision making, and care options. J Urol. 2017. pii: S0022-5347(17)78003-2. https://doi.org/10.1016/j.juro.2017.11.095. [Epub ahead of print].
- 20.Inoue S, Shiina H, Arichi N, Mitsui Y, Hiraoka T, Wake K, et al. Identification of lymphatic pathway involved in the spreading of prostate cancer by fluorescence navigation approach with intraoperatively injected indocyanine green. Can Urol Assoc J. 2011;5(4):254–9.CrossRefPubMedPubMedCentralGoogle Scholar
- 25.Abdollah F, Sood A, Sammon JD, Hsu L, Beyer B, Moschini M, et al. Long-term cancer control outcomes in patients with clinically high-risk prostate cancer treated with robot-assisted radical prostatectomy: results from a multi-institutional study of 1100 patients. Eur Urol. 2015;68(3):497–505.CrossRefPubMedGoogle Scholar
- 28.Sagalovich D, Calaway A, Srivastava A, Sooriakumaran P, Tewari AK. Assessment of required nodal yield in a high risk cohort undergoing extended pelvic lymphadenectomy in robotic-assisted radical prostatectomy and its impact on functional outcomes. BJU Int. 2013;111(1):85–94.CrossRefPubMedGoogle Scholar
- 30.Jung JH, Seo JW, Lim MS, Lee JW, Chung BH, Hong SJ, et al. Extended pelvic lymph node dissection including internal iliac packet should be performed during robot-assisted laparoscopic radical prostatectomy for high-risk prostate cancer. Journal of Laparoendosc Adv Surg Tech A. 2012;22(8):785–90.CrossRefGoogle Scholar