A systematic review and meta-analysis of comparative studies on the efficacy of extended pelvic lymph node dissection in patients with clinically localized prostatic carcinoma

Abstract

ePLND shows benefits associated with increased LNs yield, LNs positivity, and safety, significantly with no risk of side effects. However, ePLND did not decrease BCR. Additional high-quality, well-designed randomized controlled trials and comparative studies with long-term follow-up results are required to define the optimal procedure for patients with clinically localized PCa.

Initial multicentre experience of 68gallium‐PSMA PET/CT guided robot‐assisted salvage lymphadenectomy: acceptable safety profile but oncological benefit appears limited

“…At present, there is variability amongst urologists in terms of lymph node dissection utilization and extent at time of primary RP . Similarly, although the role of staging has been established, the therapeutic benefit of lymph node dissection in the primary setting remains controversial . In the salvage setting it is even more complicated to delineate the role of targeted vs extended template dissections, when looking at existing studies, given the significant variability in primary dissection indication and extent, previous radiotherapy to the pelvis and the accuracy of restaging imaging techniques used .…”

Therapeutic role of systematic lymphadenectomy in early-stage endometrial cancer: A systematic review

“…A similar story emerges from systematic reviews of lymphadenectomy to treat for other malignancies, including prostatic cancer (37) and gastric cancer (38,39). These reviews come to divergent conclusions, and the overall evidence of clinical benefit is weak.…”

Clinical management and research priorities for high-risk prostate cancer in the UK: Meeting report of a multidisciplinary panel in conjunction with the NCRI Prostate Cancer Clinical Studies Localised Subgroup

“…While it is accepted that extended lymph-node dissection may improve biochemical relapse rates and certainly provide good staging information, it has not yet been consistently shown to improve survival, and there are no randomised trials exploring this issue. 36,37 Furthermore, the place and relative benefit of extended lymph-node dissections within the context of contemporary post-surgical adjuvant therapy is unknown. The group noted that in this context there was an opportunity to explore complementary roles for different modalities for treatment of the prostate and lymph nodes within a trial setting.…”