Total submission of pelvic lymphadenectomy tissues removed during radical prostatectomy for prostate cancer increases lymph node yield and detection of micrometastases

Perry-Keene, Joanna; Ferguson, Peter M.; Samaratunga, Hemamali; Nacey, John N.; Delahunt, Brett

doi:10.1111/his.12262

Cited by 33 publications

(22 citation statements)

References 35 publications

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“…In one population-based study with a 10-year follow-up, patients undergoing excision of at least 10 nodes (node-negative patients) had a lower risk of prostate cancer-specific mortality at 10 years than those who did not undergo lymphadenectomy (15). However, the number of dissected lymph nodes is considered to be a secondary result, as the number of dissected lymph nodes is also affected by pathological examinations (20), and the secure removal of connective tissue including the lymph nodes in the dissection area is likely to be more important than the number of dissected lymph nodes. An expansion of the pelvic cavity is required by urologists so that larger quantities of connective tissue, including lymph nodes, are able to be removed, and the dissection of connective tissues must be performed to the greatest extent possible, in order to eliminate localized microscopic metastases surgically.…”

Section: Extent Of Plnd ---------------------------------------------mentioning

confidence: 99%

Determination of adequate pelvic lymph node dissection range for Japanese males undergoing radical prostatectomy

Furubayashi

Negishi

Iwai

et al. 2017

Molecular and Clinical Oncology

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Abstract. The present study aimed to determine the adequate pelvic lymph node dissection (PLND) range for Japanese males undergoing radical prostatectomy. A total of 467 Japanese patients who underwent antegrade radical prostatectomy at the National Kyushu Cancer Center (Fukuoka, Japan) were retrospectively reviewed. The patients were divided into two groups according to the PLND extent: The standard (obturator + internal iliac nodes) group and the expanded (standard + additional nodes) group, which accounted for 64.5% (301/467) and 35.5% (166/467) of the patients, respectively. No differences were observed in the preoperative and postoperative characteristics of the two groups. In addition, there was no difference in PSA recurrence between the two groups. There were no differences between the standard and expanded groups in the low-, intermediate-and high-risk groups (P=0.1456, P=0.1581, P=0.2125, respectively). The median number of lymph node dissection was 13 and 19, in the standard and expanded groups respectively (P<0.0001). However, regarding the number of lymph node metastases and the rate of patients with lymph node metastasis, no significant difference was observed between the standard and expanded groups (P=0.4219 and P=0.4257, respectively). According to multivariate analysis, a significant difference in the presence of lymph node metastasis (hazard ratio 3.547; P=0.0247), but not in the PLND extent, was detected in patients with prostate specific antigen failure (P=0.0655). When expanding the dissection extent, the number of dissected lymph nodes increases, but is not associated with the number or rate of positive lymph nodes. Thus, the current dissection range is considered to be appropriate for Japanese men undergoing radical prostatectomy.

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Section: Extent Of Plnd ---------------------------------------------mentioning

confidence: 99%

Determination of adequate pelvic lymph node dissection range for Japanese males undergoing radical prostatectomy

Furubayashi

Negishi

Iwai

et al. 2017

Molecular and Clinical Oncology

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“…A recent study by Perry-Keene et al 18 has shown that the mean number of lymph nodes was increased from 3.7 to 10.8 when all the tissue was embedded in pelvic lymphadenectomies. Deng et al reviewed whether enhanced detection of micrometastases in periprostatic tissue could be achieved using immunohistochemistry.…”

Section: Discussionmentioning

confidence: 98%

Pathological analysis of lymph nodes in anterior prostatic fat excised at robot-assisted radical prostatectomy

et al. 2014

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“…Using this approach, a single lymph node may be oversampled and also counted more than once, since several different pieces can be obtained by the pathologist, especially in the case of large lymph nodes, while small metastatic lymph nodes may be overlooked. To avoid this problem, a recent report suggested using a technique that involves submitting all nodal and perinodal tissue, and examining palpable lymph nodes and the remaining tissue separately 30 . Consistently with this view, in the light of our finding that ENE has a certain prognostic importance in PCa, and the fact that it may be a very focal aspect in a metastatic lymph node, we would emphasize the importance of examining the whole of each lymph node, however large.…”

Section: Discussionmentioning

confidence: 99%

Extranodal extension of lymph node metastasis influences recurrence in prostate cancer: a systematic review and meta-analysis

Luchini

Fleischmann

Boormans

et al. 2017

Sci Rep

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The extranodal extension (ENE) of nodal metastasis involves the extension of neoplastic cells through the lymph node capsule into the perinodal adipose tissue. This morphological feature has recently been indicated as an important prognostic factor in various cancer types, but its role in prostate cancer is still unclear. We aimed to clarify it, performing the first meta-analysis on this issue, comparing prognostic parameters in surgically treated, node-positive prostate cancer patients with (ENE+) vs. without (ENE−) ENE. Data were summarized using risk ratios (RRs) for number of deaths/recurrences and hazard ratios (HRs), with 95% confidence intervals (CI), for the time-dependent risk related to ENE positivity. Six studies followed-up 1,113 patients with N1 prostate cancer (658 ENE+ vs. 455 ENE−) for a median of 83 months. The presence of ENE was associated with a significantly higher risk of biochemical recurrence (RR = 1.15; 95%CI: 1.03–1.28; I2 = 0%; HR = 1.40, 95%CI: 1.12–1.74; I2 = 0%) and “global” (biochemical recurrence and distant metastasis) recurrence (RR = 1.15; 95%CI: 1.04–1.28; I2 = 0%; HR = 1.41, 95%CI: 1.14–1.74; I2 = 0%). ENE emerged as a potential prognostic moderator, earmarking a subgroup of patients at higher risk of recurrence. It may be considered for the prognostic stratification of metastatic patients. New possible therapeutic approaches may explore more in depth this prognostic parameter.

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Total submission of pelvic lymphadenectomy tissues removed during radical prostatectomy for prostate cancer increases lymph node yield and detection of micrometastases

Abstract: Submission of all pelvic lymphadenectomy tissue for histological examination improves the yield of lymph nodes and the detection of metastatic prostate cancer.

Cited by 33 publications

References 35 publications

Determination of adequate pelvic lymph node dissection range for Japanese males undergoing radical prostatectomy

Determination of adequate pelvic lymph node dissection range for Japanese males undergoing radical prostatectomy

Pathological analysis of lymph nodes in anterior prostatic fat excised at robot-assisted radical prostatectomy

Extranodal extension of lymph node metastasis influences recurrence in prostate cancer: a systematic review and meta-analysis

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