Effectiveness of extended pelvic lymphadenectomy in the survival of prostate cancer: a systematic review and meta-analysis

García‐Perdomo, Herney Andrés; Correa-Ochoa, Jose Jaime; Contreras-García, Ricardo; Daneshmand, Siamak

doi:10.5173/ceju.2018.1703

Cited by 14 publications

(11 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Prostate cancer (PCa) is the main cause of cancer-related mortality in males and the diagnosis, treatment, and care of these patients places a major burden on healthcare systems globally. In countries with a large proportion of elderly men, the morbidity rate associated with PCa remains high (1). Clinically, PCa is highly heterogeneous, ranging from indolent tumors to highly aggressive disease (2).…”

Section: Introductionmentioning

confidence: 99%

Liquid Biopsy in Oligometastatic Prostate Cancer—A Biologist's Point of View

et al. 2019

View full text Add to dashboard Cite

Prostate cancer (PCa) is the main cause of cancer-related mortality in males and the diagnosis, treatment, and care of these patients places a great burden on healthcare systems globally. Clinically, PCa is highly heterogeneous, ranging from indolent tumors to highly aggressive disease. In many cases treatment—generally either radiotherapy (RT) or surgery—can be curative. Several key genetic and demographic factors such as age, family history, genetic susceptibility, and race are associated with a high incidence of PCa. While our understanding of PCa, which is mainly based on the tools of molecular biology—has improved dramatically in recent years, efforts to better understand this complex disease have led to the identification of a new type of PCa–oligometastatic PCa. Oligometastatic disease should be considered an individual, heterogeneous entity with distinct metastatic phenotypes and, consequently, wide prognostic variability. In general, patients with oligometastatic disease typically present less biologically aggressive tumors whose metastatic potential is more limited and which are slow-growing. These patients are good candidates for more aggressive treatment approaches. The main aim of the presented review was to evaluate the utility of liquid biopsy for diagnostic purposes in PCa and for use in monitoring disease progression and treatment response, particularly in patients with oligometastatic PCa. Liquid biopsies offer a rapid, non-invasive approach whose use t is expected to play an important role in routine clinical practice to benefit patients. However, more research is needed to resolve the many existing discrepancies with regard to the definition and isolation method for specific biomarkers, as well as the need to determine the most appropriate markers. Consequently, the current priority in this field is to standardize liquid biopsy-based techniques. This review will help to improve understanding of the biology of PCa, particularly the recently defined condition known as “oligometastatic PCa”. The presented review of the body of evidence suggests that additional research in molecular biology may help to establish novel treatments for oligometastatic PCa. In the near future, the treatment of PCa will require an interdisciplinary approach involving active cooperation among clinicians, physicians, and biologists.

show abstract

Section: Introductionmentioning

confidence: 99%

Liquid Biopsy in Oligometastatic Prostate Cancer—A Biologist's Point of View

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Guidelines from both the American Urological Association and European Association of Urology (EAU) recommend PLND with an extended template in patients with intermediateand high-risk PCa as an expert opinion under situations without distinct evidence of the oncological bene ts of PLND [18,19]. Some systematic reviews and meta-analysis referred to oncological outcomes, but most consisted of reports with low levels of evidence, and furthermore, there are considerable variations in the LN yield and the positive rate of metastasis [7][8][9][10]. However, recent reports found a modest superiority for PLND regarding the effects of BCR-free survival with hazard risks of approximately 0.6-0.7 [8,9].…”

Section: Discussionmentioning

confidence: 99%

“…Some systematic reviews and meta-analysis referred to oncological outcomes, but most consisted of reports with low levels of evidence, and furthermore, there are considerable variations in the LN yield and the positive rate of metastasis [7][8][9][10]. However, recent reports found a modest superiority for PLND regarding the effects of BCR-free survival with hazard risks of approximately 0.6-0.7 [8,9].…”

Section: Discussionmentioning

confidence: 99%

“…However, there are pros and cons in systematic reviews regarding the direct bene t of PLND on oncological outcome. Even if this is the case, the majority of the results are only for biochemical recurrence (BCR)-free survival [7][8][9][10], and it is consistent that expanding the template results in more complications [11]. A long-awaited randomized controlled trial (RCT) did not demonstrate better oncological outcomes for extended PLND during radical prostatectomy, despite suggesting the potential bene ts of BCR-free survival in high-grade PCa [12].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Extended Pelvic Lymph Node Dissection during Robotic Prostate Surgery Reduces Biochemical Recurrence: A Propensity Score- matched Analysis for High-risk Prostate Cancer

Yashi

Yokoyama

Nakamura

et al. 2022

Preprint

View full text Add to dashboard Cite

Objectives To avoid misunderstandings based on the failure to demonstrate oncological benefit from extended pelvic lymph node dissection (PLND) during radical prostatectomy in a recent randomized controlled trial. We evaluated early survival outcome in contemporary patients with limited to high-risk prostate cancer (PCa) using propensity score (PS)-matched analysis. Materials and Methods Three-hundred and forty-seven patients with high-risk PCa were enrolled. They were determined to have a lymph node (LN) involvement probability of greater than 5%. Biochemical recurrence (BCR)-free survival was compared between two groups divided by adherence with extended template and timeframe related to improving PLND procedure. Results The mean LN yield was 23.4 and 2.7, and the positive LN rate was 19.3 and 2.0% in the extended PLND and other groups, respectively. In the entire unmatched cohort, the estimated curve was 13.1% superior in 3-year BCR-free survival for the extended PLND group. The PS-matched cohort was converged in each LN yield group to 99 patients, and the difference in the 3-year BCR-free survival widened to 22.2% (hazard ratio 0.46, 95% confidence interval 0.27–0.80; p = 0.005). The statistical difference was consistent in standard high-risk PCa, and was a significant trend in very high-risk PCa. In the analysis of two groups divided by timeframe, the difference in the BCR-free survival was a significant trend. Conclusion The results possibly demonstrate the therapeutic role of extended PLND in high-risk PCa. Statistical demonstration of benefits depends on the quality of extended PLND and whether the study cohort is the optimal composition of cancer risk.

show abstract

“…En varones adultos con cáncer de próstata localizado de riesgo bajo, intermedio o alto o localmente avanzado, en quienes se decida realizar prostatectomía radical (PR) más linfadenectomía pélvica (LP) como primera opción terapéutica, ¿se debería realizar linfadenectomía extendida (LPex) o linfadenectomía estándar (Lpe)?Evidencia: En la búsqueda sistemática se encontraron cuatro[23][24][25][26] …”

unclassified

Guía de práctica clínica para el tamizaje, diagnóstico y tratamiento inicial de cáncer de próstata localizado y localmente avanzado en el Seguro Social del Perú (EsSalud)

Cuentas-Jara

Goicochea-Lugo

Delgado‐Flores

et al. 2021

Rev. Cuerpo Med. HNAAA

View full text Add to dashboard Cite

Introducción: El presente artículo resume la guía de práctica clínica (GPC) para el tamizaje, diagnóstico, y tratamiento inicial del cáncer de próstata localizado y localmente avanzado en el Seguro Social del Perú (EsSalud). Objetivo: Proveer recomendaciones clínicas basadas en evidencia para el tamizaje, diagnóstico, y tratamiento inicial de adultos con cáncer de próstata localizado y localmente avanzado en EsSalud. Material y Métodos: Se conformó un grupo elaborador de la guía (GEG) que incluyó médicos especialistas y metodólogos, el cual formuló preguntas clínicas. Se realizaron búsquedas sistemáticas de revisiones sistemáticas y –cuando fue considerado pertinente– estudios primarios en PubMed durante el 2020 y 2021. Se seleccionó la evidencia para responder cada una de las preguntas clínicas planteadas. Se evaluó la certeza de evidencia usando la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE). En reuniones de trabajo periódicas, el GEG usó la metodología GRADE para revisar la evidencia y formular las recomendaciones. La GPC fue revisada por expertos externos antes de su aprobación. Resultados: La GPC abordó 06 preguntas clínicas, divididas en 03 temas: tamizaje, diagnóstico, y tratamiento inicial. En base a dichas preguntas se formularon 08 recomendaciones (04 fuertes y 04 condicionales), 10 puntos de buena práctica clínica, y 04 flujogramas. Conclusión: Se emitieron recomendaciones basadas en evidencia para el manejo de pacientes con esta patología..

show abstract

Effectiveness of extended pelvic lymphadenectomy in the survival of prostate cancer: a systematic review and meta-analysis

Cited by 14 publications

References 24 publications

Liquid Biopsy in Oligometastatic Prostate Cancer—A Biologist's Point of View

Liquid Biopsy in Oligometastatic Prostate Cancer—A Biologist's Point of View

Extended Pelvic Lymph Node Dissection during Robotic Prostate Surgery Reduces Biochemical Recurrence: A Propensity Score- matched Analysis for High-risk Prostate Cancer

Guía de práctica clínica para el tamizaje, diagnóstico y tratamiento inicial de cáncer de próstata localizado y localmente avanzado en el Seguro Social del Perú (EsSalud)

Contact Info

Product

Resources

About