INTRODUCTION: We examined the quantity and localization of pelvic lymph node (LN) metastases in patients undergoing extended pelvic lymphadenectomy (ePLND).
MATERIALS AND METHODS: A total of 174 patients with intermediate and high-risk prostate cancer underwent radical prostatectomy (RP) and ePLND. We analyzed the relationship between the number of LNs removed and the number, frequency and topography of LN metastases.
RESULTS: In group 1 (intermediate risk patients, n=115) the average number of LNs removed was 20.5, LN metastases were found in 15 patients (13 %) and the localizations were in the external iliac artery 19 %, the internal iliac artery 32 %, the obturator foramen 36 %, the common iliac artery 7 %, Marcille's triangle 3 % and sacral regions 3 %. In group 2 (high-risk patients, n=59) the average number of LNs removed was 23.9, LN metastases were found in 19 patients (32 %) and the localizations were the external iliac artery 15 %, the internal iliac artery 26 %, the obturator foramen 19 %, the common iliac artery 29 %, Marcille's triangle 6 % and sacral regions 5 %. The full number of metastases was detected only if more than 15 LNs were removed in group 1 and 18 LNs in group 2.
CONCLUSIONS: At least 15 LNs in the intermediate risk group and at least 18 LNs in high risk group should be removed. The ePLND should include the common iliac artery, the internal iliac artery, Marcille's triangle and sacral regions.
Written by:
Osmonov DK, Boller A, Aksenov A, Naumann M, Jünemann KP. Are you the author?
Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig Holstein, Campus Kiel, Arnold-Heller-Straße 3, Hs. 18, 24105, Kiel, Deutschland.
Reference: Urologe A. 2012 Nov 14. Epub ahead of print.
doi: 10.1007/s00120-012-3005-4
PubMed Abstract
PMID: 23150089
Article in German.
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