کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3878502 1599007 2007 5 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Standard Versus Limited Pelvic Lymph Node Dissection for Prostate Cancer in Patients With a Predicted Probability of Nodal Metastasis Greater Than 1%
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیماری‌های کلیوی
پیش نمایش صفحه اول مقاله
Standard Versus Limited Pelvic Lymph Node Dissection for Prostate Cancer in Patients With a Predicted Probability of Nodal Metastasis Greater Than 1%
چکیده انگلیسی

PurposeWe determined the yield of standard vs limited pelvic lymphadenectomy in patients with a predicted risk of lymph node metastasis greater than 1% according to the Partin tables predicted probability of pathological stage. We also determined the feasibility of laparoscopic standard pelvic lymph node dissection.Materials and MethodsOf 1,269 patients with clinically localized prostate cancer undergoing radical prostatectomy, 648 had a Partin’s table predicted probability of lymph node invasion greater than 1%. Of the 648 patients 177 underwent limited pelvic lymph node dissection performed laparoscopically (group 1), and 471 underwent standard pelvic lymph node dissection performed open (367) or laparoscopically (104) (group 2). Templates of limited pelvic lymph node dissection included the external iliac lymph nodes whereas standard pelvic lymph node dissection included the external iliac, obturator and hypogastric lymph nodes. Multivariate logistic regression analyses were performed to compare the node positivity rate between groups 1 and 2.ResultsOn multivariate logistic regression analysis controlling for prostate specific antigen, biopsy Gleason sum, clinical stage and surgical approach, the odds of node positivity were 7.15-fold higher (95% CI 2.49–20.5, p <0.001) for standard vs limited pelvic lymph node dissection. The median (mean) number of nodes retrieved was 9 (10) and 14 (15) after limited and standard pelvic lymph node dissection, respectively (p <0.001). A similar impact was observed in patients treated laparoscopically with standard vs limited pelvic lymph node dissection (odds ratio 15.6, 95% CI 3.7–66.4, p <0.001).ConclusionsStandard lymph node dissection yields positive nodes more frequently and retrieves a higher total nodal count than the often performed pelvic lymph node dissection limited to the external iliac nodes. Standard pelvic lymph node dissection is feasible through a transperitoneal laparoscopic approach.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: The Journal of Urology - Volume 178, Issue 1, July 2007, Pages 120–124
نویسندگان
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