Extended pelvic lymph node dissection including internal iliac packet should be performed during robot-assisted laparoscopic radical prostatectomy for high-risk prostate cancer
The indication and anatomic limits of pelvic lymph node dissection (PLND) have not been clearly defined. Therefore, we assessed whether the extent of PLND at robot-assisted laparoscopic radical prostatectomy (RALP) had any benefit on lymph node yield, staging accuracy, and biochemical recurrence (BC...
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| Veröffentlicht in: | Journal of laparoendoscopic & advanced surgical techniques. Part A 2012-10, Vol.22 (8), p.785-790 |
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| container_title | Journal of laparoendoscopic & advanced surgical techniques. Part A |
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| creator | Jung, Jae Hung Seo, Joo Wan Lim, Meng Shi Lee, Jae Won Chung, Byung Ha Hong, Sung Joon Song, Jae Mann Rha, Koon Ho |
| description | The indication and anatomic limits of pelvic lymph node dissection (PLND) have not been clearly defined. Therefore, we assessed whether the extent of PLND at robot-assisted laparoscopic radical prostatectomy (RALP) had any benefit on lymph node yield, staging accuracy, and biochemical recurrence (BCR) in patients with high-risk prostate cancer.
Between July 2005 and July 2010, a retrospective analysis was performed on 200 patients with high-risk prostate cancer stratified by D'Amico classification. The study population was divided into different groups: patients in Group 1 had standard PLND, and Group 2 had extended PLND (ePLND). The clinicopathologic findings of patients and surgical outcomes of PLND with each procedure were measured. Kaplan-Meier and log rank tests were used to estimate BCR-free survival rates. Univariate and multivariate survival analyses were done with the Cox proportional hazard regression model.
Medians of 15 (interquartile range, 11-19) and 24 (interquartile range, 18-28) lymph nodes were dissected in Groups 1 and 2, respectively (P |
| doi_str_mv | 10.1089/lap.2011.0516 |
| format | Article |
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Between July 2005 and July 2010, a retrospective analysis was performed on 200 patients with high-risk prostate cancer stratified by D'Amico classification. The study population was divided into different groups: patients in Group 1 had standard PLND, and Group 2 had extended PLND (ePLND). The clinicopathologic findings of patients and surgical outcomes of PLND with each procedure were measured. Kaplan-Meier and log rank tests were used to estimate BCR-free survival rates. Univariate and multivariate survival analyses were done with the Cox proportional hazard regression model.
Medians of 15 (interquartile range, 11-19) and 24 (interquartile range, 18-28) lymph nodes were dissected in Groups 1 and 2, respectively (P<.001). The incidences of lymph node metastasis were 5.2% (8/155) in Group 1 and 22.2% (10/45) in Group 2. Regardless of the extent of PLND, the patients with positive lymph nodes had a significantly lower BCR-free survival than those with negative lymph nodes. Twenty-five percent (7/27) of positive lymph nodes were in the internal iliac packet and common iliac packet. In particular, of the positive internal iliac nodes, 75% (3/4) of nodes were found in that location, exclusively.
An ePLND that identifies patients with lymph node metastasis including the internal iliac packet during RALP provides an accurate pathologic staging and may have survival benefits in high-risk prostate cancer.</description><identifier>ISSN: 1092-6429</identifier><identifier>EISSN: 1557-9034</identifier><identifier>DOI: 10.1089/lap.2011.0516</identifier><identifier>PMID: 22967037</identifier><language>eng</language><publisher>United States</publisher><subject>Aged ; Humans ; Lymph Node Excision - methods ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Recurrence, Local - epidemiology ; Neoplasm Staging ; Proportional Hazards Models ; Prostatectomy - methods ; Prostatic Neoplasms - mortality ; Prostatic Neoplasms - pathology ; Prostatic Neoplasms - surgery ; Robotics</subject><ispartof>Journal of laparoendoscopic & advanced surgical techniques. Part A, 2012-10, Vol.22 (8), p.785-790</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c293t-c09f3659fd3c625f84f9e08d553255b710a64e9b8495203d1585abc1b32ac2653</citedby><cites>FETCH-LOGICAL-c293t-c09f3659fd3c625f84f9e08d553255b710a64e9b8495203d1585abc1b32ac2653</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22967037$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jung, Jae Hung</creatorcontrib><creatorcontrib>Seo, Joo Wan</creatorcontrib><creatorcontrib>Lim, Meng Shi</creatorcontrib><creatorcontrib>Lee, Jae Won</creatorcontrib><creatorcontrib>Chung, Byung Ha</creatorcontrib><creatorcontrib>Hong, Sung Joon</creatorcontrib><creatorcontrib>Song, Jae Mann</creatorcontrib><creatorcontrib>Rha, Koon Ho</creatorcontrib><title>Extended pelvic lymph node dissection including internal iliac packet should be performed during robot-assisted laparoscopic radical prostatectomy for high-risk prostate cancer</title><title>Journal of laparoendoscopic & advanced surgical techniques. Part A</title><addtitle>J Laparoendosc Adv Surg Tech A</addtitle><description>The indication and anatomic limits of pelvic lymph node dissection (PLND) have not been clearly defined. Therefore, we assessed whether the extent of PLND at robot-assisted laparoscopic radical prostatectomy (RALP) had any benefit on lymph node yield, staging accuracy, and biochemical recurrence (BCR) in patients with high-risk prostate cancer.
Between July 2005 and July 2010, a retrospective analysis was performed on 200 patients with high-risk prostate cancer stratified by D'Amico classification. The study population was divided into different groups: patients in Group 1 had standard PLND, and Group 2 had extended PLND (ePLND). The clinicopathologic findings of patients and surgical outcomes of PLND with each procedure were measured. Kaplan-Meier and log rank tests were used to estimate BCR-free survival rates. Univariate and multivariate survival analyses were done with the Cox proportional hazard regression model.
Medians of 15 (interquartile range, 11-19) and 24 (interquartile range, 18-28) lymph nodes were dissected in Groups 1 and 2, respectively (P<.001). The incidences of lymph node metastasis were 5.2% (8/155) in Group 1 and 22.2% (10/45) in Group 2. Regardless of the extent of PLND, the patients with positive lymph nodes had a significantly lower BCR-free survival than those with negative lymph nodes. Twenty-five percent (7/27) of positive lymph nodes were in the internal iliac packet and common iliac packet. In particular, of the positive internal iliac nodes, 75% (3/4) of nodes were found in that location, exclusively.
An ePLND that identifies patients with lymph node metastasis including the internal iliac packet during RALP provides an accurate pathologic staging and may have survival benefits in high-risk prostate cancer.</description><subject>Aged</subject><subject>Humans</subject><subject>Lymph Node Excision - methods</subject><subject>Lymphatic Metastasis</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - epidemiology</subject><subject>Neoplasm Staging</subject><subject>Proportional Hazards Models</subject><subject>Prostatectomy - methods</subject><subject>Prostatic Neoplasms - mortality</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Prostatic Neoplasms - surgery</subject><subject>Robotics</subject><issn>1092-6429</issn><issn>1557-9034</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9UctOwzAQtBCIlseRK_KRS4ofcRofUcVLqsQFzpFjO9TgxMF2EP0rPpGtCuxlV-vZmfUOQheULCip5bVX44IRShdE0OoAzakQy0ISXh5CTSQrqpLJGTpJ6Y1ASF4eoxljsloSvpyj79uvbAdjDR6t_3Qa-20_bvAQjMXGpWR1dmHAbtB-Mm54hSrbOCiPnXdK41Hpd5tx2oTJG9xaoIldiD0QminuBmJoQy5USi5l6MK-KoakwwhiURmngWuETlYZxEK_xTCPN-51U0SX3v_fsFaDtvEMHXXKJ3v-m0_Ry93t8-qhWD_dP65u1oVmkudCE9nxSsjOcF0x0dVlJy2pjRCcCdEuKVFVaWVbl1Iwwg0VtVCtpi1nSrNK8FN0tecF_Y_Jptz0LmnrvRpsmFIDtxWlELKuAFrsoRpWTdF2zRhdr-IWQM3OpAY-3exManYmAf7yl3pq4VD_6D9X-A_C05Ip</recordid><startdate>201210</startdate><enddate>201210</enddate><creator>Jung, Jae Hung</creator><creator>Seo, Joo Wan</creator><creator>Lim, Meng Shi</creator><creator>Lee, Jae Won</creator><creator>Chung, Byung Ha</creator><creator>Hong, Sung Joon</creator><creator>Song, Jae Mann</creator><creator>Rha, Koon Ho</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201210</creationdate><title>Extended pelvic lymph node dissection including internal iliac packet should be performed during robot-assisted laparoscopic radical prostatectomy for high-risk prostate cancer</title><author>Jung, Jae Hung ; Seo, Joo Wan ; Lim, Meng Shi ; Lee, Jae Won ; Chung, Byung Ha ; Hong, Sung Joon ; Song, Jae Mann ; Rha, Koon Ho</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c293t-c09f3659fd3c625f84f9e08d553255b710a64e9b8495203d1585abc1b32ac2653</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Aged</topic><topic>Humans</topic><topic>Lymph Node Excision - methods</topic><topic>Lymphatic Metastasis</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - epidemiology</topic><topic>Neoplasm Staging</topic><topic>Proportional Hazards Models</topic><topic>Prostatectomy - methods</topic><topic>Prostatic Neoplasms - mortality</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Prostatic Neoplasms - surgery</topic><topic>Robotics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jung, Jae Hung</creatorcontrib><creatorcontrib>Seo, Joo Wan</creatorcontrib><creatorcontrib>Lim, Meng Shi</creatorcontrib><creatorcontrib>Lee, Jae Won</creatorcontrib><creatorcontrib>Chung, Byung Ha</creatorcontrib><creatorcontrib>Hong, Sung Joon</creatorcontrib><creatorcontrib>Song, Jae Mann</creatorcontrib><creatorcontrib>Rha, Koon Ho</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of laparoendoscopic & advanced surgical techniques. 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Part A</jtitle><addtitle>J Laparoendosc Adv Surg Tech A</addtitle><date>2012-10</date><risdate>2012</risdate><volume>22</volume><issue>8</issue><spage>785</spage><epage>790</epage><pages>785-790</pages><issn>1092-6429</issn><eissn>1557-9034</eissn><abstract>The indication and anatomic limits of pelvic lymph node dissection (PLND) have not been clearly defined. Therefore, we assessed whether the extent of PLND at robot-assisted laparoscopic radical prostatectomy (RALP) had any benefit on lymph node yield, staging accuracy, and biochemical recurrence (BCR) in patients with high-risk prostate cancer.
Between July 2005 and July 2010, a retrospective analysis was performed on 200 patients with high-risk prostate cancer stratified by D'Amico classification. The study population was divided into different groups: patients in Group 1 had standard PLND, and Group 2 had extended PLND (ePLND). The clinicopathologic findings of patients and surgical outcomes of PLND with each procedure were measured. Kaplan-Meier and log rank tests were used to estimate BCR-free survival rates. Univariate and multivariate survival analyses were done with the Cox proportional hazard regression model.
Medians of 15 (interquartile range, 11-19) and 24 (interquartile range, 18-28) lymph nodes were dissected in Groups 1 and 2, respectively (P<.001). The incidences of lymph node metastasis were 5.2% (8/155) in Group 1 and 22.2% (10/45) in Group 2. Regardless of the extent of PLND, the patients with positive lymph nodes had a significantly lower BCR-free survival than those with negative lymph nodes. Twenty-five percent (7/27) of positive lymph nodes were in the internal iliac packet and common iliac packet. In particular, of the positive internal iliac nodes, 75% (3/4) of nodes were found in that location, exclusively.
An ePLND that identifies patients with lymph node metastasis including the internal iliac packet during RALP provides an accurate pathologic staging and may have survival benefits in high-risk prostate cancer.</abstract><cop>United States</cop><pmid>22967037</pmid><doi>10.1089/lap.2011.0516</doi><tpages>6</tpages></addata></record> |
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| subjects | Aged Humans Lymph Node Excision - methods Lymphatic Metastasis Male Middle Aged Neoplasm Recurrence, Local - epidemiology Neoplasm Staging Proportional Hazards Models Prostatectomy - methods Prostatic Neoplasms - mortality Prostatic Neoplasms - pathology Prostatic Neoplasms - surgery Robotics |
| title | Extended pelvic lymph node dissection including internal iliac packet should be performed during robot-assisted laparoscopic radical prostatectomy for high-risk prostate cancer |
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