Extended lymph node dissection for prostate cancer

Jeschke, Stephan; Burkhard, Fiona C.; Thurairaja, Ramesh; Dhar, Nivedita; Studer, Urs E.

doi:10.1007/s11934-008-0041-0

Cited by 10 publications

(4 citation statements)

References 50 publications

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“…In these situations, often, urologists will dissect the obturator, external iliac, hypogastric (internal iliac) and common iliac nodes; however, additional nodes in presacral, paraaortic, pararectal and paravesical regions can be involved and dissected as illustrated in lymphoscintigraphic studies of the prostate. [8][9][10] These studies have confirmed the lymphatic drainage of the prostate to be unique and that different nodal groups can be affected independently of each other with authors reporting that up to 40% of lymph nodal involvement (LNI) can be missed with a limited node dissection alone. 11,12 This variability in the extended dissection template makes it difficult to compare results with documented average nodal yields for an ePLND ranging from 11.6 to 28.…”

Section: Discussionmentioning

confidence: 99%

“…While it is generally accepted that a limited nodal dissection removes the obturator package and the standard dissection additionally involves dissection of the external iliac nodes, there is no standardization or universally accepted operative template regarding the extended lymph node dissection. In these situations, often, urologists will dissect the obturator, external iliac, hypogastric (internal iliac) and common iliac nodes; however, additional nodes in presacral, paraaortic, pararectal and paravesical regions can be involved and dissected as illustrated in lymphoscintigraphic studies of the prostate . These studies have confirmed the lymphatic drainage of the prostate to be unique and that different nodal groups can be affected independently of each other with authors reporting that up to 40% of lymph nodal involvement (LNI) can be missed with a limited node dissection alone …”

Section: Discussionmentioning

confidence: 99%

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Extended pelvic lymph node dissection for clinically localized prostate cancer: a West Australian experience

Picardo

Vivian

2015

ANZ Journal of Surgery

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Extended pelvic lymph node dissection for clinically localized prostate cancer: a West Australian experience

Picardo

Vivian

2015

ANZ Journal of Surgery

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“…Intraoperatively, the radioactive SNs can be detected with a gamma-ray detection probe. Both open and laparoscopic approaches have been extensively studied in prostate cancer although there is a shift toward the less invasive laparoscopic and robot-assisted techniques [ 48 , 62 , 63 ].…”

Section: Methodsmentioning

confidence: 99%

Beyond penile cancer, is there a role for sentinel node biopsy in urological malignancies?

Brouwer

Poel

Bevers

et al. 2016

Clin Transl Imaging

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This review aims to discuss the current state-ofthe-art of sentinel node (SN) mapping in urological malignancies. The principles and methodological aspects of lymphatic mapping and SN biopsy in urological malignancies are reviewed. Literature search was restricted to English language. The references of the retrieved articles were examined to identify additional articles. The review also includes meta-analyses published in the past 5 years. SN biopsy for penile cancer is recommended by the European Association of Urology as the preferred staging tool for clinically node-negative patients with at least T1G2 tumours (level of evidence 2a, Grade B). The feasibility of SN biopsy in prostate cancer has been repeatedly demonstrated and its potential value is increasingly being recognised. However, conclusive prospective clinical data as well as consensus on methodology and patient selection are still lacking. For bladder, renal and testicular cancer, only few studies have been published, and concerns around high false-negative rates remain. Throughout the years, the urooncological field has portrayed a pivotal role in the development of the SN concept. Recent advances such as hybrid tracers and novel intraoperative detection tools such as fluorescence and portable gamma imaging will hopefully encourage prospectively designed clinical trials which can further substantiate the potential of the SN approach in becoming an integral part of staging in urological malignancies beyond penile cancer.

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“…Data from surgical series have shown that the combination of RP and extended PLNDs can improve biochemical‐free progression and potentially DSS [72,73]. There is also known to be a direct relationship between the number of LNs removed at surgery and PFS and CSS whether or not they harbour obvious metastatic disease [74,75]. In a recent study of 614 men by Schiavina et al .…”

Section: Role Of Ln Therapy In High‐risk Prostate Cancermentioning

confidence: 99%

The role of surgery in high‐risk localised prostate cancer

et al. 2011

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The optimal management of high‐risk localised prostate cancer is a major challenge for urologists and oncologists. It is clear that multimodal therapy including radical local treatment is needed in these men to achieve the best outcomes. External beam radiotherapy (EBRT) is an essential component of therapy either as a primary or adjuvant treatment. However, the role of radical prostatectomy (RP) is more controversial. Both methods are currently valid therapy options. There have been many individual studies of EBRT and RP in high‐risk disease, but no good quality large prospective randomized trials. In EBRT, combination with neoadjuvant plus long‐term adjuvant androgen‐deprivation therapy (ADT) has been conclusively shown to improve outcomes and is widely considered the standard of care. However, the role of RP has achieved recent prominence with several important studies. Published data from prospective randomized trials in patients after RP have shown that in men with adverse pathological features at surgery, the addition of adjuvant RT improves biochemical‐free and progression‐free survival. More recently, studies from large‐volume centres comparing EBRT and RP have provided intriguing suggestions of better outcomes with RP as the primary treatment. An important question therefore, is which of the two methods provides the best outcome in men with localised high‐risk disease. Crucially, does the combination of RP and selective adjuvant EBRT provide clinically significant better outcomes compared with EBRT alone? In this review we discuss the current evidence for the role of RP for high‐risk localised prostate cancer and define the parameters and urgent need for a prospective trial to test the role of surgery for this group of patients.

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Extended lymph node dissection for prostate cancer

Cited by 10 publications

References 50 publications

Extended pelvic lymph node dissection for clinically localized prostate cancer: a West Australian experience

Extended pelvic lymph node dissection for clinically localized prostate cancer: a West Australian experience

Beyond penile cancer, is there a role for sentinel node biopsy in urological malignancies?

The role of surgery in high‐risk localised prostate cancer

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