Standard versus extended pelvic lymphadenectomy in the patients with clinically localized prostate cancer
Background/Aim. Pelvic lymph node dissection (PLND) is the most accurate staging procedure in the diagnosis of lymph node involvement by prostate cancer. However, the therapeutic value of this procedure is still unclear. The objective of the study was to compare diagnostic and therapeutic values of...
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Military Health Department, Ministry of Defance, Serbia
2019-01-01
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doaj-65afadd99b9d4bbf98142df6713339132020-11-25T01:48:51ZengMilitary Health Department, Ministry of Defance, SerbiaVojnosanitetski Pregled0042-84502406-07202019-01-0176992993410.2298/VSP170320076B0042-84501900076BStandard versus extended pelvic lymphadenectomy in the patients with clinically localized prostate cancerBogdanović Jovo0Sekulić Vuk1Trivunić-Dajko Sandra2Herin Ranko3Đozić Senjin4Clinical Center of Vojvodina, Clinic of Urology, Novi Sad, Serbia + University of Novi Sad, Faculty of Medicine, Novi Sad, SerbiaClinical Center of Vojvodina, Clinic of Urology, Novi Sad, Serbia + University of Novi Sad, Faculty of Medicine, Novi Sad, SerbiaUniversity of Novi Sad, Faculty of Medicine, Novi Sad, Serbia + Clinical Center of Vojvodina, Center for Pathology and Histology, Novi Sad, SerbiaClinical Center of Vojvodina, Clinic of Urology, Novi Sad, SerbiaClinical Center of Vojvodina, Clinic of Urology, Novi Sad, SerbiaBackground/Aim. Pelvic lymph node dissection (PLND) is the most accurate staging procedure in the diagnosis of lymph node involvement by prostate cancer. However, the therapeutic value of this procedure is still unclear. The objective of the study was to compare diagnostic and therapeutic values of extended and standard PLND as an adjunct of radical prostatectomy. Methods. The patients who underwent surgical treatment for clinically localized prostate cancer (n = 157) were enrolled in this open nonrandomized prospective study. In the standard PLND (sPLND) group 109 patients were enrolled while the extended PLND (ePLND) group involved 48 patients. Both groups were compared regarding age, prostate-specific antigen (PSA) level, a percentage of positive biopsies, preoperative and postoperative Gleason score, number of retrieved and positive lymph nodes, duration of surgery, blood loss, amount of lymphorrhea and biochemical recurrence-free survival. Results. The average number of retrieved lymph nodes was 17.27 and 24.46 in the sPLND and ePLND group, respectively (p = 0.001). The rate of positive lymph nodes was 9/109 (8.3%) and 8/48 (16.7%) in the sPLND and ePLND groups, respectively. Biochemical recurrence was noted in 38/109 (31.2%) and 7/48 (14.6%) patients in the sPLND and ePLND group, respectively (p = 0.003). Conclusion. Comparison of sPLND to ePLND led to the following conclusions: nodal yield was significantly higher in the ePLND group; the ePLND template was associated with a much higher rate of lymph node metastases; the biochemical recurrence-free survival rate was significantly more favorable in the ePLND group comparing to the sPLND group.http://www.doiserbia.nb.rs/img/doi/0042-8450/2019/0042-84501900076B.pdflymph node excisionpelvisprostatic neoplasmsprostatectomysurgical procedures, operative |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Bogdanović Jovo Sekulić Vuk Trivunić-Dajko Sandra Herin Ranko Đozić Senjin |
spellingShingle |
Bogdanović Jovo Sekulić Vuk Trivunić-Dajko Sandra Herin Ranko Đozić Senjin Standard versus extended pelvic lymphadenectomy in the patients with clinically localized prostate cancer Vojnosanitetski Pregled lymph node excision pelvis prostatic neoplasms prostatectomy surgical procedures, operative |
author_facet |
Bogdanović Jovo Sekulić Vuk Trivunić-Dajko Sandra Herin Ranko Đozić Senjin |
author_sort |
Bogdanović Jovo |
title |
Standard versus extended pelvic lymphadenectomy in the patients with clinically localized prostate cancer |
title_short |
Standard versus extended pelvic lymphadenectomy in the patients with clinically localized prostate cancer |
title_full |
Standard versus extended pelvic lymphadenectomy in the patients with clinically localized prostate cancer |
title_fullStr |
Standard versus extended pelvic lymphadenectomy in the patients with clinically localized prostate cancer |
title_full_unstemmed |
Standard versus extended pelvic lymphadenectomy in the patients with clinically localized prostate cancer |
title_sort |
standard versus extended pelvic lymphadenectomy in the patients with clinically localized prostate cancer |
publisher |
Military Health Department, Ministry of Defance, Serbia |
series |
Vojnosanitetski Pregled |
issn |
0042-8450 2406-0720 |
publishDate |
2019-01-01 |
description |
Background/Aim. Pelvic lymph node dissection (PLND) is the most accurate staging procedure in the diagnosis of lymph node involvement by prostate cancer. However, the therapeutic value of this procedure is still unclear. The objective of the study was to compare diagnostic and therapeutic values of extended and standard PLND as an adjunct of radical prostatectomy. Methods. The patients who underwent surgical treatment for clinically localized prostate cancer (n = 157) were enrolled in this open nonrandomized prospective study. In the standard PLND (sPLND) group 109 patients were enrolled while the extended PLND (ePLND) group involved 48 patients. Both groups were compared regarding age, prostate-specific antigen (PSA) level, a percentage of positive biopsies, preoperative and postoperative Gleason score, number of retrieved and positive lymph nodes, duration of surgery, blood loss, amount of lymphorrhea and biochemical recurrence-free survival. Results. The average number of retrieved lymph nodes was 17.27 and 24.46 in the sPLND and ePLND group, respectively (p = 0.001). The rate of positive lymph nodes was 9/109 (8.3%) and 8/48 (16.7%) in the sPLND and ePLND groups, respectively. Biochemical recurrence was noted in 38/109 (31.2%) and 7/48 (14.6%) patients in the sPLND and ePLND group, respectively (p = 0.003). Conclusion. Comparison of sPLND to ePLND led to the following conclusions: nodal yield was significantly higher in the ePLND group; the ePLND template was associated with a much higher rate of lymph node metastases; the biochemical recurrence-free survival rate was significantly more favorable in the ePLND group comparing to the sPLND group. |
topic |
lymph node excision pelvis prostatic neoplasms prostatectomy surgical procedures, operative |
url |
http://www.doiserbia.nb.rs/img/doi/0042-8450/2019/0042-84501900076B.pdf |
work_keys_str_mv |
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