Pelvic lymph node dissection in high-risk prostate cancer

Haiquel, Luciano; Cathelineau, Xavier; Sánchez-Salas, Rafael; Macek, Petr; Secín, Fernando P.

doi:10.1590/s1677-5538.ibju.2020.1063

Cited by 6 publications

(3 citation statements)

References 74 publications

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“…It has previously been reported that prostatitis and the symptoms of inflammatory prostate are associated with an increased risk of prostate cancer ( 1 , 2 ). Bacterial infections may cause chronic inflammation in the prostate, leading to increased production of inflammatory cytokines.…”

Section: Discussionmentioning

confidence: 99%

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Detection of bacterial agents causing prostate infection by culture and molecular methods from biopsy specimens

Karami¹,

Javadi²,

Salehi³

et al. 2022

IJM

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Background and Objectives: Prostatitis affects about 16% of men in their lifetime and sometimes leading to prostate cancer. Bacterial infections are the most common causes of prostatitis. Diagnosis of the causative agents of bacterial prostate infections plays an essential role in timely treating and preventing secondary complications. This study isolat- ed bacterial infectious agents in patients’ surgical prostate and evaluated them by routine and molecular microbiological methods. Materials and Methods: In this cross-sectional study, 72 prostate biopsy specimens were collected from the Orology De- partmen of hospitals of Qazvin University of Medical Sciences. All samples were cultured in aerobic and anaerobic condi- tions. Antibiotic susceptibility test by Kirby-Bauer standard method was performed for all isolated bacteria. In addition, all isolated bacteria were identified using 16S rDNA PCR and sanger sequencing methods. Also, TaqMan real-time PCR was applied to detect Ureaplasm aurealyticum, Mycoplasma hominins, and Mycoplasma genitalium. Results: In conventional culture method, out of 18 positive samples, 15 samples (83.3%) were Gram-negative bacteria and 3 samples (16.6%) were Gram-positive bacteria, containing Escherichia coli (55.5%), Klebsiella pneumoniae (11.1%), En- terobacter cloacae (5.5%), Pseudomonas aeruginosa (11.1%), Staphylococcus aureus (11.1%), and Enterococcus faecalis (5.5%). The results of molecular identification methods were the same as conventional culture results. Also, four patients were Ureaplasm aurealyticum, and three patients were positive for Mycoplasma hominis. Conclusion: Most bacteria isolated from prostate specimens belonged to the Enterobacteriaceae family, especially Esch- erichia coli, Klebsiella pneumoniae, Enterobacter cloacae. Staphylococcus aureus and Enterococcus faecalis were cocci isolated in the specimens too. Also, Ureaplasma urealyticum, and Mycoplasma hominis were identified in prostatitis.

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Section: Discussionmentioning

confidence: 99%

“…Prostate is part of the male reproductive system that plays a role in semen production ( 1 ). The natural volume of this gland is 30 ml to 40 ml.…”

Section: Introductionmentioning

confidence: 99%

Detection of bacterial agents causing prostate infection by culture and molecular methods from biopsy specimens

Karami¹,

Javadi²,

Salehi³

et al. 2022

IJM

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“…The therapeutic role of extended LND to remove occult micrometastases in PCa patients undergoing RP probably existed ( 9 ); due to the low incidence of lymph node metastases in RP, populations in the studies were relatively small. Moreover, EAU risk stratification based on D’Amico stratification was commonly applied for stratifying patients who received extended LND or limited LND ( 15 , 16 ); this stratification system was mainly predicting biochemical recurrence, and its prognostic utility may be weak. It was obvious that the extent of LND was meaningless for lymph node-negative patients; LND aimed to eliminate the cancerous lymph node.…”

Section: Discussionmentioning

confidence: 99%

The survival benefit of different lymph node yields in radical prostatectomy for pN1M0 prostate cancer patients: Implications from a population-based study

Liu

et al. 2022

Front. Oncol.

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Background and objectivesThe extent and survival benefits of lymph node dissection (LND) in radical prostatectomy (RP) for pN1M0 prostate cancer (PCa) patients remained unclear and were controversial. This study aimed to determine the survival benefit of different lymph node yields in RP for pN1M0 PCa patients.MethodspN1M0 PCa patients who received RP and LND were identified in Surveillance Epidemiology and End Results (SEER) (2010–2015). Patients were divided into two groups in SEER based on the removal of one to three regional lymph nodes (LND1 group) or four or more regional lymph nodes (LND4 group). Kaplan–Meier methods were used to calculate cancer-specific survival (CSS) and overall survival (OS).ResultsIn total, 2,200 patients were identified; 264 patients received LND1 and 1,936 patients received LND4. CSS had no significant difference between the LND4 and LND1 groups (101mon vs. 98mon, p = 0.064), and OS was higher in LND4 patients compared with LND1 patients (97mon vs. 93mon, p = 0.024); for patients with Gleason score = 9 or 10 and T3b or T4, 5-year OS was higher in patients undergoing LND4 (80.9%; 95% CI, 79.0–82.8) compared with those undergoing LND1 (67.5%; 95% CI, 60.8–74.2) (p = 0.009).ConclusionMore lymph node yield provided better survival for patients with Gleason score = 9 or 10 and T3b or T4, but not for other pN1M0 PCa patients. The extent of LND would be determined after a comprehensive evaluation including Gleason score, tumor stage, and the general condition of the patient.

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Proficiency score as a predictor of early trifecta achievement during the learning curve of robot-assisted radical prostatectomy for high-risk prostate cancer: Results of a multicentric series

et al. 2023

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Background: Recently, an innovative tool called "proficiency score" was introduced to assess the learning curve for robot-assisted radical prostatectomy (RARP). However, the initial study only focused on patients with low-risk prostate cancer for whom pelvic lymph node dissection (PLND) was not required. To address this issue, we aimed to validate proficiency scores of a contemporary multicenter cohort of patients with high-risk prostate cancer treated with RARP plus extended PLND by trainee surgeons. Material and methods: Between 2010 and 2020, 4 Italian institutional prostate-cancer datasets were merged and queried for "RARP" and "high-risk prostate cancer." High-risk prostate cancer was defined according to the most recent European Association of Urology guidelines as follows: prostate-specific antigen >20 ng/mL, International Society of Urological Pathology ≥4, and/or clinical stage (cT) ≥ 2c on preoperative imaging. The selected cohort (n = 144) included clinical cases performed by trainee surgeons (n = 4) after completing their RARP learning curve (50 procedures for low-risk prostate cancer). The outcome of interest, the proficiency score, was defined as the coexistence of all the following criteria: a comparable operation time to the interquartile range of the mentor surgeon at each center, absence of any significant perioperative complications Clavien-Dindo Grade 3-5, no perioperative blood transfusions, and negative surgical margins. A logistic binary regression model was built to identify the predictors of 1-year trifecta achievement in the trainee cohort. For all statistical analyses, a 2-sided p < 0.05 was considered significant. Results: A proficiency score was achieved in 42.3% patients. At univariable level, proficiency score was associated with 1-year trifecta achievement (odds ratio, 8.77; 95% confidence interval, 2.42-31.7; p = 0.001). After multivariable adjustments for age, nerve-sparing, and surgical technique, the proficiency score independently predicted 1-year trifecta achievement (odds ratio, 9.58; 95% confidence interval, 1.83-50.1; p = 0.007). Conclusions: Our findings support the use of proficiency scores in patients and require extended PLND in addition to RARP.

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Pelvic lymph node dissection in high-risk prostate cancer

Cited by 6 publications

References 74 publications

Detection of bacterial agents causing prostate infection by culture and molecular methods from biopsy specimens

Detection of bacterial agents causing prostate infection by culture and molecular methods from biopsy specimens

The survival benefit of different lymph node yields in radical prostatectomy for pN1M0 prostate cancer patients: Implications from a population-based study

Proficiency score as a predictor of early trifecta achievement during the learning curve of robot-assisted radical prostatectomy for high-risk prostate cancer: Results of a multicentric series

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