OBJECTIVES: To prospectively assess contemporary complication rates of minimally-invasive staging pelvic lymph node dissection before curative radiotherapy for prostate cancer using a standardized classification.
METHODS: A total of 100 prostate cancer patients underwent laparoscopic or robot-assisted pelvic lymph node dissection (95% extended). Surgical outcomes were compared with those of 43 patients undergoing open pelvic lymph node dissection (33% extended). Complications were recorded prospectively during hospitalization and follow-up visits, and graded using Clavien-Dindo classification. Lymphocele size was measured on postoperative magnetic resonance imaging or computed tomography.
RESULTS: Of the complications recorded, 10% were grade 1, 3% were grade 2 and 6% were grade 3. No grade 4-5 complications occurred. Compared with open pelvic lymph node dissection, minimally-invasive pelvic lymph node dissection was associated with less blood loss (P = 0.001) and shorter hospital stay (median 3 vs 6 days; P < 0.001), but longer operation time (130 vs 98 min; P < 0.001). The complication rate was similar in both groups. For the entire cohort, overall and symptomatic lymphoceles were seen in 91 (64%) and 18 patients (13%), respectively. On multivariate logistic regression, minimally-invasive surgery was the only independent predictor for lymphocele development (odds ratio 3.99; P = 0.015).
CONCLUSIONS: Minimally-invasive extended pelvic lymph node dissection before curative radiotherapy is associated with low morbidity. Asymptomatic lymphocele development rate is higher compared with open pelvic lymph node dissection.
Written by:
Van Praet C, Decaestecker K, Fonteyne V, Ost P, De Visschere P, Verschuere S, Rottey S, Lumen N. Are you the author?
Department of Urology, Ghent University Hospital, Ghent, Belgium.
Reference: Int J Urol. 2014 Jun 25. Epub ahead of print
doi: 10.1111/iju.12534
PubMed Abstract
PMID: 24964296
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