Extended vs standard pelvic lymphadenectomy during laparoscopic radical prostatectomy for intermediate‐ and high‐risk prostate cancer

• Published in: BJU international 2010-08, Vol.106 (4), p.537-542
• Main Authors: Eden, Christopher G., Arora, Avanish, Rouse, Paul
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Gynecology. Andrology. Obstetrics; Humans; laparoscopy; Lymph Node Excision - adverse effects; Lymph Node Excision - methods; Lymph Nodes - pathology; Lymph Nodes - surgery; Lymphatic Metastasis; Male; Male genital diseases; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Pelvis; prostate cancer; Prostatectomy - adverse effects; Prostatectomy - methods; Prostatic Neoplasms - pathology; Prostatic Neoplasms - surgery; radical prostatectomy; Risk Factors; Treatment Outcome; Tumors; Tumors of the urinary system; Urinary tract. Prostate gland
• ISSN: 1464-4096; 1464-410X
• DOI: 10.1111/j.1464-410X.2009.09161.x

Study Type – Therapy (case series)
Level of Evidence 4 OBJECTIVE To investigate the effect of extended vs standard pelvic lymphadenectomy (sPLND) for patients with intermediate‐ and high‐risk prostate cancer undergoing laparoscopic radical prostatectomy (LRP). PATIENTS AND METHODS Of a total of 1269 patients who underwent LRP during a 109 month period, 374 (30%) had a PLND; 253 men had a sPLND (2000 to March 2008) and 121 had an extended PLND (ePLND; after April 2008) for intermediate‐ or high‐risk prostate cancer. An extraperitoneal approach was used in all patients having sPLND and a transperitoneal approach in patients having ePLND. RESULTS Patient age, body mass index, gland weight, prostate‐specific antigen level and Gleason grade were similar in the two groups. The ePLND group had a greater proportion of patients with cT3 disease (9.9% vs 4.2%, P = 0.046) and was associated with a longer operating time of 206.5 vs 180.0 min (P