717 Longterm Outcome Following Radical Prostatectomy for Gleason 8-10 Prostatic Adenocarcinoma- Analysis of 75,416 Patients

Pokala, Naveen; Trulson, Jerry; Kiran, Ravi P.

doi:10.1016/j.juro.2013.02.276

Cited by 2 publications

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“…PLND was standard in one study [23], while its extension was not reported in the other five studies [19,20,26,27,32]. None of these studies demonstrated any statistically significant differences in cancer-specific mortality [20,23,26,27,32] and overall mortality [19,23] (Table 3b). One study was a RCT [9].…”

Section: Cancer-specific and Overall Mortalitymentioning

confidence: 96%

“…3.4.1.1 No PLND vs. any form of PLNDOverall, 21 retrospective comparative studies (15 full-text articles and 6 conference abstracts) compared no PLND vs. any form of PLND for oncological Biochemical recurrence was evaluated in 18 studies, in which 5/18 [28%] involved lPLND, 1/18 [5%] sPLND, 3/18 [17%] ePLND, and 9/18 [50%] undefined PLND. Out of these, 16 did not find any statistically significant difference between the two groups[16][17][18]21,[23][24][25][27][28][29][30][31][33][34][35][36]. This negative finding also applied to the various sub-groups of patients (e.g.…”

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confidence: 99%

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The benefits and harms of different extents of lymph node dissection during radical prostatectomy for prostate cancer: A systematic review

Fossati¹,

Willemse²,

Broeck³

et al. 2018

European Urology Supplements

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Context. Controversy exists regarding the therapeutic role of pelvic lymph node dissection (PLND) in patients undergoing radical prostatectomy for prostate cancer. Objective. To systematically review the relevant literature assessing the relative benefits and harms of PLND on oncological and non-oncological outcomes in patients undergoing radical prostatectomy for prostate cancer. Evidence acquisition. Medline, Medline In-Process, Embase, and the Cochrane Central Register of Controlled Trials were searched up to December 2015. Comparative studies evaluating no PLND, limited, standard, and (super)-extended PLND and reporting on oncological and non-oncological outcomes were included. Risk-of-bias and confounding assessments were performed. A narrative synthesis was undertaken. Evidence synthesis. Overall, 66 studies recruiting a total of 275,269 patients were included (44 full-text articles and 22 conference abstracts). Oncological outcomes were addressed by 29 studies, one of which was a randomized clinical trial (RCT). Non-oncological outcomes were addressed by 43 studies, three of which were RCTs. There were high risks of bias and confounding across most studies. Conflicting results emerged when comparing biochemical and clinical recurrence, while no significant differences were observed among groups for survival. Conversely, the majority of studies showed that the more extensive the PLND, the greater the adverse outcomes in terms of operating time, blood loss, length of stay and postoperative complications. No significant differences were observed in terms of urinary continence and erectile function recovery. Conclusion. Although representing the most accurate staging procedure, PLND and its extension are associated with worse intra-operative and peri-operative outcomes, whereas a direct therapeutic effect is still not evident from the current literature. The current poor quality of evidence indicates the need for robust and adequately powered clinical trials. Patient summary. Based on a comprehensive review of the literature, this article summarises the benefits and harms of removing lymph nodes during surgery to remove the prostate for cancer. Although the quality of the data from studies was poor, the review suggests lymph node removal may not have any direct benefit on cancer outcomes and may instead result in more complications. Nevertheless, the procedure is still justified because it enables accurate assessment of cancer spread.

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Section: Cancer-specific and Overall Mortalitymentioning

confidence: 96%

mentioning

confidence: 99%

The benefits and harms of different extents of lymph node dissection during radical prostatectomy for prostate cancer: A systematic review

Fossati¹,

Willemse²,

Broeck³

et al. 2018

European Urology Supplements

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“…Mitsuzuka Cancer-specific and overall mortality Cancer-specific and overall mortality were analysed by 6 studies. Of these, PLND was standard in one study [23], while its extension was not reported in the other five studies [19,20,26,27,32]. None of these studies demonstrated any statistically significant differences in cancer-specific mortality [20,23,26,27,32] and overall mortality [19,23] (Table 3b).…”

Section: Distant Metastasismentioning

confidence: 98%

The Benefits and Harms of Different Extents of Lymph Node Dissection During Radical Prostatectomy for Prostate Cancer: A Systematic Review

et al. 2017

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The use of online course material is the approach adopted by most universities to support students' revision, and teachers usually have the responsibility for designing or uploading online materials on their own course websites. However, some teachers might lack programming skills or motivation, and most current online materials are just uploaded in a static format (such as PDF) which is not suitable for all students. Moreover, during revision periods students may be faced with a lot of unorganised materials to be revised in a short period of time, and this can lead to an ineffective revision process. In order to address these issues, this paper proposes a software framework that aims to maximise the benefit of current online materials when used to support student revision. This framework is called SRECMATs (Self-Revision E-Course MATerials) and has been deployed as a tool that allows teachers to automatically create an intelligent tutoring system to manage online materials without any programming knowledge, and to support students to navigate easily through these online materials during their revision. This paper evaluates the proposed framework in order to understand students' perceptions with regard to the use of the system prototype, and the results indicate which features are suitable for providing online revision materials as well as confirming the benefit of the revision framework.

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717 Longterm Outcome Following Radical Prostatectomy for Gleason 8-10 Prostatic Adenocarcinoma- Analysis of 75,416 Patients

Cited by 2 publications

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The benefits and harms of different extents of lymph node dissection during radical prostatectomy for prostate cancer: A systematic review

The benefits and harms of different extents of lymph node dissection during radical prostatectomy for prostate cancer: A systematic review

The Benefits and Harms of Different Extents of Lymph Node Dissection During Radical Prostatectomy for Prostate Cancer: A Systematic Review

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