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

We performed robot-assisted radical prostatectomy (RARP) for 221 patients from December 2015 to May 2023. In 218 patients, the prostatic anterior fat pad was submitted separately for histopathological evaluation. Fourteen patients (6.4%) had lymph nodes in the prostatic anterior fat pad, and three (1.4%) had lymph node metastasis in the prostatic anterior fat pad. The details of three cases are presented here.Case 1 was a 63-year-old patient who underwent RARP for prostate cancer (cT2aN0M0), with an initial prostate-specific antigen (PSA) concentration of 24.522 ng/ml and a Gleason score of 3+4. The pathological results indicated adenocarcinoma, pT3a, Gleason score: 3+4. The postoperative PSA nadir was 0.205 ng/ml, and the patient was diagnosed with biochemical recurrence. Subsequently, the patient underwent hormone therapy and salvage radiation therapy, with no recurrence to date.Case 2 was a 62-year-old patient who underwent RARP for prostate cancer (cT2aN0M0), with an initial PSA of 10.418 ng/ml and a Gleason score of 4+4. The pathological results indicated adenocarcinoma, pT2c, Gleason score: 4+4. The postoperative PSA nadir was 0.401 ng/ml, and the patient was diagnosed with biochemical recurrence. The patient subsequently underwent hormone therapy.Case 3 was a 76-year-old patient who underwent RARP for prostate cancer (cT2aN0M0), with an initial PSA of 4.676 ng/ml and a Gleason score of 4+3. The pathological results indicated adenocarcinoma, pT2c, Gleason score: 3+4. The postoperative PSA nadir was 0.031 ng/ml, and the patient has not experienced recurrence to date.