Radical Prostatectomy with Extended Pelvic Lymphadenectomy: Impact of Separate Vs. En Bloc Lymph Node Submission on Pathohistological Analysis
Introduction: In prostate cancer (PC), it is well established that the wider the anatomical template of dissection, the higher the number of lymph nodes (LNs) retrieved, and the higher the nodal yield, the better the detection of metastasis1,2. Objectives: The objectives of this study were to eva...
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Sestre Milosrdnice University hospital, Institute of Clinical Medical Research
2024-01-01
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| Series: | Acta Clinica Croatica |
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| Online Access: | https://hrcak.srce.hr/file/467121 |
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| author | Dorian Srok Gordana Đorđević Dean Markić Josip Španjol Kristian Krpina |
| author_facet | Dorian Srok Gordana Đorđević Dean Markić Josip Španjol Kristian Krpina |
| author_sort | Dorian Srok |
| collection | DOAJ |
| description | Introduction: In prostate cancer (PC), it is well established that the wider the
anatomical template of dissection, the higher the number of lymph nodes (LNs) retrieved, and the
higher the nodal yield, the better the detection of metastasis1,2.
Objectives: The objectives of this study were to evaluate if the change in submission methodology
(en bloc vs. separate) had an impact on the number of total LNs identified per patient and the number
of positive LNs found, and to determine the impact of individual pathologists on the number of total
LNs and positive LNs.
Patients and methods: We performed a retrospective analysis of hospital records of patients with
PC in whom radical prostatectomy (RP) with pelvic lymphadenectomy (PLND) was done in the
period from November 2012 to December 2018. We used only a single-surgeon series in order to
avoid performance bias in the lymphadenectomy template. Pathohistological examinations were performed
by our hospital’s two dedicated urogenital pathologists. Patients were divided into high and
intermediate risk groups according to the European Association of Urology (EAU) guidelines, based
on submission methodology of the lymphadenectomy tissue and by the pathologist performing the
examinations. The number of LNs and number of positive LNs acquired were then compared using
the Mann-Whitney test.
Results: Patients who underwent separate submission of lymphadenectomy tissue had a significantly
higher nodal yield, but there was no difference in the number of positive LNs. There was no significant
difference in the total number of LNs acquired and LN metastases detected between our two pathologists
when comparing them by submission technique.
Conclusions: Separate submission of lymphadenectomy tissue resulted in a higher nodal yield, but it
did not translate to a higher number of positive LNs found. |
| format | Article |
| id | doaj-art-6ff4a351582348d2a7cde42daae2bcd2 |
| institution | OA Journals |
| issn | 0353-9466 1333-9451 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Sestre Milosrdnice University hospital, Institute of Clinical Medical Research |
| record_format | Article |
| series | Acta Clinica Croatica |
| spelling | doaj-art-6ff4a351582348d2a7cde42daae2bcd22025-08-20T02:21:29ZengSestre Milosrdnice University hospital, Institute of Clinical Medical ResearchActa Clinica Croatica0353-94661333-94512024-01-0163.Supplement 2455010.20471/acc.2024.63.s2.7Radical Prostatectomy with Extended Pelvic Lymphadenectomy: Impact of Separate Vs. En Bloc Lymph Node Submission on Pathohistological AnalysisDorian Srok0Gordana Đorđević1Dean Markić2Josip Španjol3Kristian Krpina4Department of Urology, Clinical Hospital Center RijekaClinical department of pathology and cytology, Clinical hospital center Rijeka, Rijeka, Croatia; Department of general pathology and pathological anatomy, Faculty of medicine, University of Rijeka, Rijeka, CroatiaDepartment of Urology, Clinical Hospital Center Rijeka; Department of urology, Faculty of medicine, University of Rijeka, Rijeka, CroatiaDepartment of Urology, Clinical Hospital Center Rijeka; Department of urology, Faculty of medicine, University of Rijeka, Rijeka, CroatiaDepartment of Urology, Clinical Hospital Center Rijeka; Department of urology, Faculty of medicine, University of Rijeka, Rijeka, CroatiaIntroduction: In prostate cancer (PC), it is well established that the wider the anatomical template of dissection, the higher the number of lymph nodes (LNs) retrieved, and the higher the nodal yield, the better the detection of metastasis1,2. Objectives: The objectives of this study were to evaluate if the change in submission methodology (en bloc vs. separate) had an impact on the number of total LNs identified per patient and the number of positive LNs found, and to determine the impact of individual pathologists on the number of total LNs and positive LNs. Patients and methods: We performed a retrospective analysis of hospital records of patients with PC in whom radical prostatectomy (RP) with pelvic lymphadenectomy (PLND) was done in the period from November 2012 to December 2018. We used only a single-surgeon series in order to avoid performance bias in the lymphadenectomy template. Pathohistological examinations were performed by our hospital’s two dedicated urogenital pathologists. Patients were divided into high and intermediate risk groups according to the European Association of Urology (EAU) guidelines, based on submission methodology of the lymphadenectomy tissue and by the pathologist performing the examinations. The number of LNs and number of positive LNs acquired were then compared using the Mann-Whitney test. Results: Patients who underwent separate submission of lymphadenectomy tissue had a significantly higher nodal yield, but there was no difference in the number of positive LNs. There was no significant difference in the total number of LNs acquired and LN metastases detected between our two pathologists when comparing them by submission technique. Conclusions: Separate submission of lymphadenectomy tissue resulted in a higher nodal yield, but it did not translate to a higher number of positive LNs found.https://hrcak.srce.hr/file/467121Prostate cancerLymphadenectomyNodal countSeparateEn Bloc |
| spellingShingle | Dorian Srok Gordana Đorđević Dean Markić Josip Španjol Kristian Krpina Radical Prostatectomy with Extended Pelvic Lymphadenectomy: Impact of Separate Vs. En Bloc Lymph Node Submission on Pathohistological Analysis Acta Clinica Croatica Prostate cancer Lymphadenectomy Nodal count Separate En Bloc |
| title | Radical Prostatectomy with Extended Pelvic Lymphadenectomy: Impact of Separate Vs. En Bloc Lymph Node Submission on Pathohistological Analysis |
| title_full | Radical Prostatectomy with Extended Pelvic Lymphadenectomy: Impact of Separate Vs. En Bloc Lymph Node Submission on Pathohistological Analysis |
| title_fullStr | Radical Prostatectomy with Extended Pelvic Lymphadenectomy: Impact of Separate Vs. En Bloc Lymph Node Submission on Pathohistological Analysis |
| title_full_unstemmed | Radical Prostatectomy with Extended Pelvic Lymphadenectomy: Impact of Separate Vs. En Bloc Lymph Node Submission on Pathohistological Analysis |
| title_short | Radical Prostatectomy with Extended Pelvic Lymphadenectomy: Impact of Separate Vs. En Bloc Lymph Node Submission on Pathohistological Analysis |
| title_sort | radical prostatectomy with extended pelvic lymphadenectomy impact of separate vs en bloc lymph node submission on pathohistological analysis |
| topic | Prostate cancer Lymphadenectomy Nodal count Separate En Bloc |
| url | https://hrcak.srce.hr/file/467121 |
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