Comparative effectiveness of minimally invasive versus open lymphadenectomy in urological cancers

Prasad, Sandip M.; Shalhav, Arieh L.

doi:10.1097/mou.0b013e32835af286

Cited by 14 publications

(4 citation statements)

References 93 publications

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“…It might be derived from a large portion of robot-assisted laparoscopic RP (RARP) in our study population (32/96, 33.3%, Table 1). As known by previous studies 24-26, the rate of PLND was significantly lower in RARP than open RP (17% vs. 83% for laparoscopic RP/RARP vs. open RP, respectively, p<0.001) 25. In addition, due to the small number of patients, significant differences could not be discerned according to the adjuvant therapy strategies between the two groups (Table 1).…”

Section: Discussionmentioning

confidence: 67%

“…A previous systematic review and meta-analysis showed a significant difference in BCR between ePLND and sPLND in PCa patients; thus, ePLND could be an oncological benefit 23. Also, the rate of PLND was relatively lower than other studies 24-26. It might be derived from a large portion of robot-assisted laparoscopic RP (RARP) in our study population (32/96, 33.3%, Table 1).…”

Section: Discussionmentioning

confidence: 69%

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Prostate specific antigen (PSA) persistence 6 weeks after radical prostatectomy and pelvic lymph node dissection as predictive factor of radiographic progression in node-positive prostate cancer patients

Kim¹,

Jeong

et al. 2019

J. Cancer

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Purpose : To evaluate the prognostic value of early postoperative prostate specific antigen (PSA) levels after radical prostatectomy (RP) and pelvic lymph node dissection (PLND) in prostate cancer patients with lymph node invasion (LNI). Materials and Methods : The retrospective analysis involved 96 patients who had a diagnosis of LNI with available data on the first PSA level at postoperative 6 weeks after RP and PLND between 2002 and 2014 at our institution. PSA persistence was defined as PSA ≥ 0.1 ng/ml at 6 weeks after surgery. Radiographic progression was defined as positive imaging during follow-up after the onset of biochemical recurrence, consisting of a bone scan and/or computed tomography (CT) and/or magnetic resonance imaging and/or 18F-(2-deoxy-2-fluoro-D-glucose positron emission tomography/CT scan. Comparative analysis of patients with and without PSA persistence was done, and Kaplan-Meier curve analysis with log-rank test and Cox proportional hazard regression models assessed radiographic progression free survival (PFS). Results : Fifty two (54.2%) patients displayed PSA persistence. Kaplan-Meier curve analysis showed significantly decreased 5-year radiographic PFS (64.2% vs. 93.2%, log-rank, p=0.009) in the PSA persistence group compared to the no PSA persistence group. In a multivariate analysis, PSA persistence was a statistically significant predictor of radiographic PFS. Conclusions : Early assessment of PSA after surgery is important for predicting radiographic progression in node-positive prostate cancer patients. Risk stratification based on the early PSA value after surgery would be helpful to identify patients who may benefit from early adjuvant therapies.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 69%

Prostate specific antigen (PSA) persistence 6 weeks after radical prostatectomy and pelvic lymph node dissection as predictive factor of radiographic progression in node-positive prostate cancer patients

Kim¹,

Jeong

et al. 2019

J. Cancer

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“…Additionally, achieving a high level of precision is crucial when performing template-based lymphadenectomy, particularly due to the complex surgical field surrounding the great vessels. Robotic systems offer increased control and greater dexterity, enabling more precise removal of lymph nodes, a higher number of resected lymph nodes, and a lower risk of complications ( 56 , 69 , 70 ). A study conducted by Clements et al in 2018 revealed that the use of the robotic-assisted approaches increases the probability of successful lymphadenectomy, which itself is a predictor of improved survival ( 71 ).…”

Section: Ral-nu: the Presentmentioning

confidence: 99%

Robotic nephroureterectomy supplanting open and laparoscopic approach for upper tract urothelial carcinoma management: a narrative review

Zuluaga,

Rich,

Razdan

et al. 2023

Transl Androl Urol

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Background and Objective The use of robotic surgery for managing upper tract urothelial carcinoma (UTUC) has increased significantly over the years. Minimally invasive techniques (MIS) are now used for approximately half of all robot-assisted laparoscopic nephroureterectomy (RAL-NU) performed in the USA. However, there are currently no specific management guidelines that recommend the use of a robotic approach, and the available literature on this topic is limited. For this reason, we reviewed the history and current literature regarding this technique. Methods We searched Web of Science and PubMed for articles between 1934 to 2023 using 20 different search terms and combinations. We restricted our selection to only publications in English language. Key Content and Findings Comparative retrospective studies between techniques [open nephroureterectomy (ONU), laparoscopic nephroureterectomy (LNU), and RAL-NU] and case series of surgical groups, mostly at short- and mid-term follow-up, were included. Conclusions Robotic surgery for UTUC is on the rise and is predicted to become the preferred method for nephroureterectomy. A comparison of RAL-NU to LNU and ONU shows several advantages, including less blood loss, pain, and hospital stay, as well as a quicker recovery time. The safety and effectiveness of robotic surgery for lymphadenectomy also supports its use in RAL-NU. As more medical facilities adopt the technique and further studies support its benefits, it is likely that robotic surgery will become the preferred method for NU.

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“…The main role of lymph node dissection is to decrease or even better eradicate the risk of recurrence [1]. Furthermore, lymph node dissection may also provide more information about disease staging or it may lead to the early recognition of lymph node metastases, offering the opportunity to the patient to start earlier the adjuvant therapy.…”

Section: Introductionmentioning

confidence: 99%

Robotic retroperitoneal lymph node dissection in gynaecological neoplasms: comparison of extraperitoneal and transperitoneal lymphadenectomy

Iavazzo

Gkegkes

2015

Arch Gynecol Obstet

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Comparative effectiveness of minimally invasive versus open lymphadenectomy in urological cancers

Abstract: Findings from the prior year suggest that - in high-volume centers - lymph node dissection for urologic cancers is equivalent between open and minimally invasive techniques in lymph node yield and short-term to medium-term oncologic results.

Cited by 14 publications

References 93 publications

Prostate specific antigen (PSA) persistence 6 weeks after radical prostatectomy and pelvic lymph node dissection as predictive factor of radiographic progression in node-positive prostate cancer patients

Prostate specific antigen (PSA) persistence 6 weeks after radical prostatectomy and pelvic lymph node dissection as predictive factor of radiographic progression in node-positive prostate cancer patients

Robotic nephroureterectomy supplanting open and laparoscopic approach for upper tract urothelial carcinoma management: a narrative review

Robotic retroperitoneal lymph node dissection in gynaecological neoplasms: comparison of extraperitoneal and transperitoneal lymphadenectomy

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