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Laparoscopic extended pelvic lymph node dissection for high-risk prostate cancer.
Urology. 2006 Oct; 68(4):883-7.U

Abstract

INTRODUCTION

Recently, some controversy has arisen as to whether pelvic lymphadenectomy is still necessary for patients with prostate cancer who are undergoing radical prostatectomy. We prospectively evaluated the results and morbidity of laparoscopic extended pelvic lymph node dissection in patients with high-risk prostate cancer defined as a serum prostate-specific antigen (PSA) level greater than 10 ng/mL or preoperative biopsy Gleason score of 7 or more.

TECHNICAL CONSIDERATIONS

In 123 consecutive patients with clinically organ-confined high-risk prostate cancer, laparoscopic extended pelvic lymphadenectomy was performed before laparoscopic radical prostatectomy. The boundaries of the pelvic lymph node dissection were the bifurcation of the common iliac artery superiorly, the node of Cloquet inferiorly, the external iliac vein laterally, and the bladder wall medially. Preparation was done with bipolar forceps and scissors, with meticulous coagulation of all lymphatic tissue. The mean PSA level was 14.8 ng/mL (range 1.5 to 43.4). The mean number of lymph nodes removed was 21 (range 9 to 55). A total of 21 patients (17%) had lymph node metastases. The overall complication rate was 4%.

CONCLUSIONS

Laparoscopic extended pelvic lymph node dissection is safe and effective. The results and morbidity are equivalent to those of open surgery, with the advantage of a minimally invasive operative technique.

Authors+Show Affiliations

Department of Urology, University Hospital Basel, Basel, Switzerland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17070376

Citation

Wyler, Stephen F., et al. "Laparoscopic Extended Pelvic Lymph Node Dissection for High-risk Prostate Cancer." Urology, vol. 68, no. 4, 2006, pp. 883-7.
Wyler SF, Sulser T, Seifert HH, et al. Laparoscopic extended pelvic lymph node dissection for high-risk prostate cancer. Urology. 2006;68(4):883-7.
Wyler, S. F., Sulser, T., Seifert, H. H., Ruszat, R., Forster, T. H., Gasser, T. C., & Bachmann, A. (2006). Laparoscopic extended pelvic lymph node dissection for high-risk prostate cancer. Urology, 68(4), 883-7.
Wyler SF, et al. Laparoscopic Extended Pelvic Lymph Node Dissection for High-risk Prostate Cancer. Urology. 2006;68(4):883-7. PubMed PMID: 17070376.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laparoscopic extended pelvic lymph node dissection for high-risk prostate cancer. AU - Wyler,Stephen F, AU - Sulser,Tullio, AU - Seifert,Hans-Helge, AU - Ruszat,Robin, AU - Forster,Thomas H, AU - Gasser,Thomas C, AU - Bachmann,Alexander, PY - 2005/11/29/received PY - 2006/03/29/revised PY - 2006/04/28/accepted PY - 2006/10/31/pubmed PY - 2006/11/10/medline PY - 2006/10/31/entrez SP - 883 EP - 7 JF - Urology JO - Urology VL - 68 IS - 4 N2 - INTRODUCTION: Recently, some controversy has arisen as to whether pelvic lymphadenectomy is still necessary for patients with prostate cancer who are undergoing radical prostatectomy. We prospectively evaluated the results and morbidity of laparoscopic extended pelvic lymph node dissection in patients with high-risk prostate cancer defined as a serum prostate-specific antigen (PSA) level greater than 10 ng/mL or preoperative biopsy Gleason score of 7 or more. TECHNICAL CONSIDERATIONS: In 123 consecutive patients with clinically organ-confined high-risk prostate cancer, laparoscopic extended pelvic lymphadenectomy was performed before laparoscopic radical prostatectomy. The boundaries of the pelvic lymph node dissection were the bifurcation of the common iliac artery superiorly, the node of Cloquet inferiorly, the external iliac vein laterally, and the bladder wall medially. Preparation was done with bipolar forceps and scissors, with meticulous coagulation of all lymphatic tissue. The mean PSA level was 14.8 ng/mL (range 1.5 to 43.4). The mean number of lymph nodes removed was 21 (range 9 to 55). A total of 21 patients (17%) had lymph node metastases. The overall complication rate was 4%. CONCLUSIONS: Laparoscopic extended pelvic lymph node dissection is safe and effective. The results and morbidity are equivalent to those of open surgery, with the advantage of a minimally invasive operative technique. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/17070376/Laparoscopic_extended_pelvic_lymph_node_dissection_for_high_risk_prostate_cancer_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-4295(06)00631-5 DB - PRIME DP - Unbound Medicine ER -