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Is there a need for pelvic lymph node dissection in low risk prostate cancer patients prior to definitive local therapy?
Eur Urol. 2005 Jan; 47(1):45-50; discussion 50-1.EU

Abstract

OBJECTIVES

In men with low risk prostate cancer the need for pelvic lymph node dissection is controversial. Therefore, we examined how many men with favorable preoperative risk factors had positive lymph nodes.

METHODS

235 men with preoperative PSA < or =10 ng/ml, Gleason score < or =6 and positive biopsies in only one lobe, had radio-guided pelvic sentinel lymph node (SLN) dissection and radical retropubic prostatectomy (RRP) or-in case of no positive lymph nodes detected-a transperineal I(125) seed implantation. Eighty-four men with positive biopsies in both lobes and identical PSA and Gleason score had SLN dissection and RRP.

RESULTS

In 187 men with positive biopsies in one lobe RRP was performed. Sixteen patients had positive lymph nodes. Median 6 SLN (mean 6.8) and 6 non-sentinel lymph nodes (NSLN) (mean 7.3) were dissected. All men with positive lymph nodes also had positive SLN. Eighty-four men with positive biopsies in both lobes had RRP. Nine men had positive lymph nodes (10.7%). A median of 6 SLN (mean 6.6) and 5 NSLN (mean 7.5) were dissected. All men with positive nodes had a single positive SLN.

CONCLUSIONS

In patients with PSA < or =10 ng/ml and biopsy Gleason score < or =6, positive lymph nodes were identified by radio-guided surgery in 6.8% (positive biopsies in one lobe) and 10.7% (positive biopsies in both lobes). Up to 4 positive SLN were found. Therefore, we suggest not to dispense with an operative lymph node staging, even in low risk disease.

Authors+Show Affiliations

Department of Urology, Klinikum Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany. dorothea.weckermann@uro.augsburg-med.deNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15582248

Citation

Weckermann, Dorothea, et al. "Is There a Need for Pelvic Lymph Node Dissection in Low Risk Prostate Cancer Patients Prior to Definitive Local Therapy?" European Urology, vol. 47, no. 1, 2005, pp. 45-50; discussion 50-1.
Weckermann D, Wawroschek F, Harzmann R. Is there a need for pelvic lymph node dissection in low risk prostate cancer patients prior to definitive local therapy? Eur Urol. 2005;47(1):45-50; discussion 50-1.
Weckermann, D., Wawroschek, F., & Harzmann, R. (2005). Is there a need for pelvic lymph node dissection in low risk prostate cancer patients prior to definitive local therapy? European Urology, 47(1), 45-50; discussion 50-1.
Weckermann D, Wawroschek F, Harzmann R. Is There a Need for Pelvic Lymph Node Dissection in Low Risk Prostate Cancer Patients Prior to Definitive Local Therapy. Eur Urol. 2005;47(1):45-50; discussion 50-1. PubMed PMID: 15582248.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is there a need for pelvic lymph node dissection in low risk prostate cancer patients prior to definitive local therapy? AU - Weckermann,Dorothea, AU - Wawroschek,Friedhelm, AU - Harzmann,Rolf, PY - 2004/07/07/accepted PY - 2004/12/8/pubmed PY - 2005/6/24/medline PY - 2004/12/8/entrez SP - 45-50; discussion 50-1 JF - European urology JO - Eur Urol VL - 47 IS - 1 N2 - OBJECTIVES: In men with low risk prostate cancer the need for pelvic lymph node dissection is controversial. Therefore, we examined how many men with favorable preoperative risk factors had positive lymph nodes. METHODS: 235 men with preoperative PSA < or =10 ng/ml, Gleason score < or =6 and positive biopsies in only one lobe, had radio-guided pelvic sentinel lymph node (SLN) dissection and radical retropubic prostatectomy (RRP) or-in case of no positive lymph nodes detected-a transperineal I(125) seed implantation. Eighty-four men with positive biopsies in both lobes and identical PSA and Gleason score had SLN dissection and RRP. RESULTS: In 187 men with positive biopsies in one lobe RRP was performed. Sixteen patients had positive lymph nodes. Median 6 SLN (mean 6.8) and 6 non-sentinel lymph nodes (NSLN) (mean 7.3) were dissected. All men with positive lymph nodes also had positive SLN. Eighty-four men with positive biopsies in both lobes had RRP. Nine men had positive lymph nodes (10.7%). A median of 6 SLN (mean 6.6) and 5 NSLN (mean 7.5) were dissected. All men with positive nodes had a single positive SLN. CONCLUSIONS: In patients with PSA < or =10 ng/ml and biopsy Gleason score < or =6, positive lymph nodes were identified by radio-guided surgery in 6.8% (positive biopsies in one lobe) and 10.7% (positive biopsies in both lobes). Up to 4 positive SLN were found. Therefore, we suggest not to dispense with an operative lymph node staging, even in low risk disease. SN - 0302-2838 UR - https://www.unboundmedicine.com/medline/citation/15582248/Is_there_a_need_for_pelvic_lymph_node_dissection_in_low_risk_prostate_cancer_patients_prior_to_definitive_local_therapy L2 - https://linkinghub.elsevier.com/retrieve/pii/S0302-2838(04)00371-9 DB - PRIME DP - Unbound Medicine ER -