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Extended pelvic lymph node dissection for clinically localized prostate cancer: a West Australian experience
Alarick Picardo1, Justin Vivian1
1Urology Department, St John of God Hospital, Perth, Western Australia, Australia.
ANZ Journal of Surgery
|March 18, 2015
Summary
In West Australian men with localized prostate cancer, extended pelvic lymph node dissection during robotic surgery revealed a 16.33% nodal positivity rate. This procedure demonstrated an acceptable complication rate, supporting its use in select patients.
Area of Science:
- Urology
- Surgical Oncology
- Robotic Surgery
Background:
- Pelvic lymph node dissection (PLND) for clinically localized prostate cancer remains controversial in Australia.
- The study addresses the need to clarify the role and optimal type of PLND in this patient population.
Purpose of the Study:
- To determine the incidence of pelvic lymph node involvement in West Australian patients with prostate cancer.
- To evaluate the complication rate associated with extended pelvic lymph node dissection (ePLND) in conjunction with robotic assisted radical prostatectomy (RARP).
Main Methods:
- A cohort of 49 patients undergoing RARP with ePLND between 2008-2012 was analyzed.
- Inclusion criteria focused on clinically localized, intermediate, and high-risk prostate cancer based on D'Amico classification.
- Data were collected by a single urological surgeon in private practice.
Main Results:
- A nodal positivity rate of 16.33% (8 out of 49 patients) was observed.
- The overall complication rate was 12.24% (6 out of 49 patients).
- Complications specifically attributed to ePLND occurred in 6.12% of patients (3 out of 49).
Conclusions:
- The observed rates of nodal involvement align with existing international literature.
- Extended pelvic lymph node dissection can be safely performed with an acceptable complication profile in this cohort.
- Further research is warranted to elucidate the therapeutic benefits of PLND in prostate cancer management.