Evaluation of complications and biochemical recurrence rates after (super) extended lymph node dissection during radical prostatectomy

Objective To evaluate the effectiveness of extended (e-PLND) and super-extended pelvic lymph node dissection (se-PLND) during robot-assisted radical prostatectomy (RARP) by examining lymph node (LN) yield, complications, LN metastasis, and biochemical recurrence (BCR) incidence. Methods Between Janu...

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Bibliographic Details
Published in:World journal of urology 2024-10, Vol.42 (1), p.605, Article 605
Main Authors: Baas, Diederik J.H., Israël, Bas, de Baaij, Joost M.S., Vrijhof, Henricus J.E.J., Hoekstra, Robert J., Kusters-Vandevelde, Heidi, Mulders, Peter F.A., Michiel Sedelaar, J. P., Somford, Diederik M., van Basten, Jean-Paul A.
Format: Article
Language:English
Subjects:
Aged
Dissection
Humans
Lymph Node Excision - methods
Lymph nodes
Lymphatic Metastasis
Lymphatic system
Male
Medicine
Medicine & Public Health
Metastases
Metastasis
Middle Aged
Neoplasm Recurrence, Local - epidemiology
Nephrology
Oncology
Pelvis
Postoperative Complications - epidemiology
Prostate-Specific Antigen - blood
Prostatectomy
Prostatectomy - methods
Prostatic Neoplasms - pathology
Prostatic Neoplasms - surgery
Retrospective Studies
Robotic surgery
Robotic Surgical Procedures
Urology
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Summary:Objective To evaluate the effectiveness of extended (e-PLND) and super-extended pelvic lymph node dissection (se-PLND) during robot-assisted radical prostatectomy (RARP) by examining lymph node (LN) yield, complications, LN metastasis, and biochemical recurrence (BCR) incidence. Methods Between January 2016 and January 2020, 354 consecutive patients with > 5% risk of lymph node involvement (LNI), as predicted by the Memorial Sloan Kettering Cancer Center nomogram, underwent RARP with (s)e-PLND at a high-volume center. The e-PLND involved removing fibrofatty lymphatic tissue around the obturator fossa, internal iliac region, and external iliac vessels. The se-PLND, performed at the discretion of the surgeons, also included lymph nodes from the pre-sacral and common iliac regions. Outcomes included histopathological findings by anatomical region; complications; and BCR incidence during follow-up. Results The median LNI risk was 18% (IQR 9–31%). A median of 22 LN (IQR 16–28) were removed, with se-PLND yielding a higher number: 25 (IQR 20–32) compared to e-PLND: 17 (IQR 13–24) ( p  
ISSN:1433-8726
0724-4983
1433-8726
DOI:10.1007/s00345-024-05321-6