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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Main Authors: Bogdanović Jovo, Sekulić Vuk, Trivunić-Dajko Sandra, Herin Ranko, Đozić Senjin
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2019-01-01
Series:Vojnosanitetski Pregled
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Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2019/0042-84501900076B.pdf
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author Bogdanović Jovo
Sekulić Vuk
Trivunić-Dajko Sandra
Herin Ranko
Đozić Senjin
author_facet Bogdanović Jovo
Sekulić Vuk
Trivunić-Dajko Sandra
Herin Ranko
Đozić Senjin
author_sort Bogdanović Jovo
collection DOAJ
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.
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spelling doaj-art-65afadd99b9d4bbf98142df6713339132025-08-20T01:57:19ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski 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
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
title 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_short 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
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
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