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Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
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Perioperative outcomes using template mapping after radical cystectomy and extended lymph node dissection.
Salvador Jaime-Casas1, Ahmad Imam2, Daniel J Lama2
1Division of Urology and Urologic Oncology, Department of Surgery, City of Hope Comprehensive Cancer Center, 1500 E Duarte Road, Duarte, 91010, CA, USA. sjaimecasas@coh.org.
BMC Urology
|April 15, 2025
Summary
The location of positive lymph nodes does not impact cancer outcomes after extended pelvic lymph node dissection during robot-assisted radical cystectomy. Extended dissection offers no significant oncologic benefit over standard procedures.
Area of Science:
- Urology
- Oncology
- Surgical Oncology
Background:
- Robot-assisted radical cystectomy (RARC) is a standard treatment for bladder cancer.
- Extended pelvic lymph node dissection (PLND) is performed during RARC.
- The impact of lymph node positivity (LN+) location on outcomes is not well-defined.
Purpose of the Study:
- To evaluate oncologic and perioperative outcomes of extended PLND during RARC.
- To compare outcomes based on the location of lymph node positivity (LN+).
Main Methods:
- Retrospective review of a tertiary center database (2004-2020).
- Patients undergoing RARC with extended PLND were divided into standard (sPLN+) and extended (ePLN+) cohorts based on LN+ location.
- Oncologic outcomes (recurrence-free survival, overall survival) and perioperative complications (Clavien-Dindo system) were analyzed.
Main Results:
- Ninety patients were included: 43 (48%) sPLN+ and 47 (52%) ePLN+.
- No significant differences in 90-day mortality, recurrence-free survival, or overall survival were observed between groups.
- Overall complication rates were high (71%) but similar between the sPLN+ and ePLN+ cohorts.
Conclusions:
- The location of lymph node positivity does not influence oncologic outcomes in patients undergoing extended PLND during RARC.
- Extended PLND does not appear to offer a significant therapeutic advantage beyond the standard dissection template.
