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[THREE CASES OF LYMPH NODE METASTASIS WITHIN THE PROSTATIC ANTERIOR FAT PAD IN ROBOT-ASSISTED RADICAL PROSTATECTOMY].

Takumi Ishikawa1, Tetsuya Murakawa1, Takanori Nate1

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Robot-assisted radical prostatectomy (RARP) identified lymph nodes in the prostatic anterior fat pad in 6.4% of patients, with 1.4% showing metastasis. This finding impacts prostate cancer staging and treatment strategies.

Keywords:
Prostate cancerlymph node metastasisprostatic anterior fat pad

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Area of Science:

  • Urology
  • Oncology
  • Pathology

Background:

  • Robot-assisted radical prostatectomy (RARP) is a common treatment for prostate cancer.
  • The prostatic anterior fat pad's role in metastasis is not fully understood.

Purpose of the Study:

  • To investigate the incidence of lymph nodes and lymph node metastasis within the prostatic anterior fat pad during RARP.
  • To analyze the clinical significance of these findings in prostate cancer patients.

Main Methods:

  • Retrospective analysis of 221 patients undergoing RARP from December 2015 to May 2023.
  • Separate histopathological evaluation of the prostatic anterior fat pad for 218 patients.

Main Results:

  • Lymph nodes were identified in the prostatic anterior fat pad in 14 out of 218 patients (6.4%).
  • Lymph node metastasis was found in 3 out of 218 patients (1.4%).
  • Three case studies detailing patients with positive lymph nodes and their outcomes are presented.

Conclusions:

  • The prostatic anterior fat pad can harbor lymph nodes, including those with metastasis, in a small but significant percentage of prostate cancer patients undergoing RARP.
  • These findings may necessitate re-evaluation of standard staging and treatment protocols.
  • Further research is warranted to understand the full implications of prostatic anterior fat pad involvement.