NARUS 2018: The Role of Extended Lymph Node Dissection in Radical Prostatectomy
Methods
This was a retrospective analysis of 113 patients operated between 2014 and 2017. All patients underwent a robotic pelvic lymph node dissection after being found to harbor a lymph node metastatic risk of at least 2%. The ePLND template included sPLND nodal packets + common iliac and hypogastric nodes. Lymph node yield and oncologic outcomes were compared between the two groups.
Results
A total of 63 patients underwent Splnd, and 70 patients underwent ePLND. No difference between the groups were found in regards to age, weight, preoperative PSA, D’Amico risk classification, or prostate size. There was a significant longer operative time in the Eplnd group (251.1 min vs. 225.1 min, p<0.01) and the median lymph node yield was significantly higher (16.9 vs. 7.9, p>0.01). However, although the BCR rate was lower in the Eplnd group (11% vs. 23%), it was not statistically significant. The mean follow-up was 15 (12.2-17.8) months in the Splnd roup and 10 (8.7-11.3) months in the Eplnd group.
Conclusions
The authors concluded that ePLND may improve BCR-free survival rates in patients with high risk disease. However, longer follow-up data is needed to assess if a statistical difference between sPLND and ePLND patients exists.
Presented By: Patel, Rutveej, Rutgers Biomedical and Health Sciences, NJ, USA
Written By: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre @GoldbergHanan at the 2018 North American Robotic Urology Symposium, February 16-17, 2018 - Las Vegas, NV