1613: Sentinel Lymph Node Resection in Prostate Cancer Patients with PSA Higher than 20 NG/ML

Gronau, E.; Weckermann, Dorothea; Harzmann, R.

doi:10.1016/s0022-5347(18)35735-5

Cited by 7 publications

(3 citation statements)

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“…Anatomic localization of prostatic sentinel nodes with fusion imaging of single photon emission computed tomography (SPECT) and CT scans after intraprostatic injection of Technetium-99m-Nanocolloid may be a more reliable imaging technique but is time consuming, costly and is dependent on the skills of the nuclear medicine specialist [23]. In addition in signiWcant nodal disease technetium uptake can be compromised so over 1/3 of positive nodes remain unidentiWed [24]. Other new and potentially promising techniques such as high resolution MRI with lymphotrophic superpara-magentic nanoparticles are being developed and evaluated, however detection of micrometastasis remains limited and these techniques are as yet not available [25].…”

Section: Clinical Stagingmentioning

confidence: 99%

The role of lymphadenectomy in high risk prostate cancer

Burkhard

Studer

2008

World J Urol

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Historically, patients with high risk prostate cancer were considered poor candidates for radical prostatectomy (RP) due to the likelihood of positive pelvic lymph nodes and decreased long term survival. Although there is still no consensus on the optimal therapy for this group of patients, there is increasing evidence that surgery could play a role. Cancer specific survival (CSS) rates after RP for locally advanced disease at 10 year follow up range from 29 to 72%, depending on tumor differentiation. The role of pelvic lymph node dissection (PLND) in prostate cancer remains a controversial topic. Nonetheless, in conjunction with RRP extended PLND (ePLND) should be performed as extended lymph node dissection in lieu of standard PLND may increase staging accuracy, influence decision making with respect to adjuvant therapy and possibly impact outcome. High risk patients with organ confined prostate cancer and low volume (micro)metastatic disease may be the ones to profit most from this approach.

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Section: Clinical Stagingmentioning

confidence: 99%

The role of lymphadenectomy in high risk prostate cancer

Burkhard

Studer

2008

World J Urol

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“…One limitation of the SLN imaging technique, however, is that in the presence of bulky nodes roughly one third of LNM may remain unrecognized due to the impaired uptake of Technetium. 85 Fortunately, markedly enlarged nodes may be identified with standard anatomic imaging techniques. The advantages and disadvantages of MR with USPIO, SN-based SPECT/CT and FCH-PET are summarized in Table 2.…”

Section: Imaging Modalities For the Evaluation Of Occult Nodal Diseasementioning

confidence: 99%

Management of prostate cancer patients with lymph node involvement: A rapidly evolving paradigm

Créhange¹,

Chen²,

Hsu³

et al. 2012

Cancer Treatment Reviews

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Although widespread PSA screening has inevitably led to increased diagnosis of lower risk prostate cancer, the number of patients with nodal involvement at baseline remains high (nearly 40% of high risk patients initially staged cN0). These rates probably do not reflect the true incidence of prostate cancer with lymph node involvement among patients selected for external beam radiotherapy (EBRT), as patients selected for surgery often have more favorable prognostic features. At many institutions, radical treatment directed only at the prostate is considered standard and patients known to have regional disease are often managed palliatively with androgen deprivation therapy (ADT) for presumed systemic disease. New imaging tools such as MR lymphangiography, choline-based PET imaging or combined SPECT/CT now allow surgeons and radiation oncologists to identify and target nodal metastasis and/or lymph nodes with a high risk of occult involvement. Recent advances in the field of surgery including the advent of extended nodal dissection and sentinel node procedures have suggested that cancer-specific survival might be improved for lymph-node positive patients with a low burden of nodal involvement when managed with aggressive interventions. These new imaging tools can provide radiation oncologists with maps to guide delivery of high dose conformal radiation to a target volume while minimizing radiation toxicity to non-target normal tissue. This review highlights advances in imaging and reports how they may help to define a new paradigm to manage node-positive prostate cancer patients with a curative-intent.

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“…By extending the dissection along the common iliac vessels at least up to the ureteric crossing, nearly 75% of all nodes potentially harboring metastasis can be removed. However, although this appears to be a reliable imaging technique it is time-consuming, costly, and dependent on the skills of the nuclear medicine specialist [25]. Because the objective is to identify and remove as many diseased nodes as possible, the role of preoperative SLN detection remains undetermined.…”

Section: Functional Imagingmentioning

confidence: 99%

Extended lymph node dissection for prostate cancer

Jeschke

Burkhard

Thurairaja³

et al. 2008

Curr Urol Rep

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Lymph node status is an important determinant for the management of patients with newly diagnosed prostate cancer. Given the significant limitations of cross-sectional and functional preoperative imaging in the detection of small metastases, pelvic lymph node dissection remains the only reliable staging method in clinically localized prostate cancer. Although lymph node dissection is a well-established form of staging in prostate cancer, controversy remains about indications and the surgical extent of the procedure. Reported practices vary from omitting pelvic lymph node dissection in low-risk disease to routine pelvic lymph node dissection in all radical prostatectomy patients. This review highlights the recent literature concerning pelvic lymphadenectomy in prostate cancer with respect to anatomical extent and oncologic outcome.

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1613: Sentinel Lymph Node Resection in Prostate Cancer Patients with PSA Higher than 20 NG/ML

Cited by 7 publications

References 0 publications

The role of lymphadenectomy in high risk prostate cancer

The role of lymphadenectomy in high risk prostate cancer

Management of prostate cancer patients with lymph node involvement: A rapidly evolving paradigm

Extended lymph node dissection for prostate cancer

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