Anatomical localization and clinical impact of sentinel lymph nodes based on patterns of pelvic lymphatic drainage in clinically localized prostate cancer

Miki, Jun; Yanagisawa, Takafumi; Tsuzuki, Shunsuke; Mori, Keiichiro; Urabe, Fumihiko; Kayano, Sotaro; Yorozu, Tomoko; Sato, Shun; Kimura, Takahiro; Takahashi, Hiroyuki; Kishimoto, Kazuya; Egawa, Shin

doi:10.1002/pros.23486

Cited by 19 publications

(30 citation statements)

References 23 publications

(34 reference statements)

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“…Sites of metastatic LNs were as follows (metastatic FLN number/total metastatic LN number): internal ileac region, 7/17; external ileac region, 5/14; obturator region, 1/8; presacral region, 1/4; and pre‐prostatic region, 1/1. The “junctional” region included seven FLNs out of 15 metastatic LNs 22 . Among 15 metastatic FLN patients, there were six patients (40%) with more than three metastatic LNs.…”

Section: Resultsmentioning

confidence: 99%

“…There have been a few reports on ICG‐based prostatic lymphatic drainage route analyses 14,17,22 . These reports seem not to have focused on the paravesical artery area.…”

Section: Discussionmentioning

confidence: 99%

“…1). Landmarks were the MUL and the ureterohypogastric fascia, which cover the hypogastric nerve and ureter 24 to preserve the autonomic nerves 22 (Fig. 1a,b).…”

Section: Methodsmentioning

confidence: 99%

“…However, the radiotracer‐guided method is problematic due to exposure of the patient to radiation and the need for protective measures. Recently, several reports of an ICG fluorescence‐imaging‐guided technique have described the feasibility and safety of SLN detection in PC 16–23 …”

Section: Introductionmentioning

confidence: 99%

“…Although we need to know the lymphatic drainage routes in surgical fields to carry out appropriate ePLND, the exact lymphatic drainage route anatomy has not been well established. In previous reports about ICG‐guided ePLND, the distribution of FLNs has often been analyzed, but just a few have commented on lymphatic drainage routes from the prostate 14,17,22 …”

Section: Introductionmentioning

confidence: 99%

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Impact of indocyanine green‐guided extended pelvic lymph node dissection during robot‐assisted radical prostatectomy

et al. 2020

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Objectives: To evaluate the effectiveness of indocyanine green-guided extended pelvic lymph node dissection during robot-assisted radical prostatectomy for intermediate-to high-risk prostate cancer. Materials and methods: After institutional review board approval, between July 2017 and December 2018, we carried out 100 indocyanine green-guided extended pelvic lymph node dissections in patients with localized intermediate-and high-risk prostate cancer, using the Firefly (Novadaq Technologies, Mississauga, ON, Canada) and da Vinci Xi surgical system (Intuitive Surgical, Sunnyvale, CA, USA). Indocyanine green was injected transrectally using ultrasound sonography before each surgery. Then, lymphatic drainage patterns and pathological findings were recorded. Results: Lymphatic drainage routes were successfully determined in 91 right-sided and 90 left-sided cases. Five main lymphatic pathways and sites were identified: (i) an internal route (57%); (ii) a lateral route (50%); (iii) a presacral route (20%); (iv) a paravesical artery site (20%); and (v) a pre-prostatic site (5%). Lymph node metastasis was positive in 15 patients, with 44 pathologically confirmed metastatic lymph nodes. Metastatic fluorescent lymph nodes were found in 15 out of 44 lymph nodes (34.1%). For sentinel lymph node identification, the 34% sensitivity and 64.8% specificity rates were detected in regard to identification of lymph node metastasis. Conclusions: Lymphatic drainage patterns from the prostate can be identified and classified using indocyanine green-guided extended pelvic lymph node dissections. Although the direct role of fluorescent lymph nodes in sentinel lymph node identification appears to be limited, the identification of lymphatic pathways could contribute to highquality extended pelvic lymph node dissection during robot-assisted radical prostatectomy.

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Section: Resultsmentioning

confidence: 99%

“…There have been a few reports on ICG‐based prostatic lymphatic drainage route analyses 14,17,22 . These reports seem not to have focused on the paravesical artery area.…”

Section: Discussionmentioning

confidence: 99%

“…1). Landmarks were the MUL and the ureterohypogastric fascia, which cover the hypogastric nerve and ureter 24 to preserve the autonomic nerves 22 (Fig. 1a,b).…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact of indocyanine green‐guided extended pelvic lymph node dissection during robot‐assisted radical prostatectomy

et al. 2020

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Clear identification of the rare solitary external iliac lymph node metastasis of testicular cancer by using indocyanine green fluorescence guidance

et al. 2021

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Introduction There are few reports on indocyanine green fluorescence‐guided surgery in testis‐related diseases. Case presentation A 38‐year‐old man underwent orchiectomy for left testicular cancer. Pathological diagnosis was pT1 seminoma. Seven years after the surgery, solitary left external iliac lymph node metastasis was suspected. We decided to perform laparoscopic lymph node dissection combined with indocyanine green fluorescence injection. During the operation, we injected indocyanine green fluorescence into his left inner inguinal ring and found that the lymph node was directly drained from the injection point. The pathological diagnosis of the indocyanine green fluorescence‐positive left external iliac lymph node was testicular cancer metastasis. Conclusion We experienced a case of solitary left external iliac lymph node recurrence in testicular cancer. Using indocyanine green fluorescence injection, we could visualize the lymphatic drainage route, which helped us identify the lymph node as the primary landing site of metastasis.

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Editorial Comment to Clear identification of the rare solitary external iliac lymph node metastasis of testicular cancer by using indocyanine green fluorescence guidance

Anatomical localization and clinical impact of sentinel lymph nodes based on patterns of pelvic lymphatic drainage in clinically localized prostate cancer

Cited by 19 publications

References 23 publications

Impact of indocyanine green‐guided extended pelvic lymph node dissection during robot‐assisted radical prostatectomy

Impact of indocyanine green‐guided extended pelvic lymph node dissection during robot‐assisted radical prostatectomy

Clear identification of the rare solitary external iliac lymph node metastasis of testicular cancer by using indocyanine green fluorescence guidance

Editorial Comment to Clear identification of the rare solitary external iliac lymph node metastasis of testicular cancer by using indocyanine green fluorescence guidance

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