Diagnostic yield and complications of extended lymphadenectomy versus limited lymphadenectomy combined with radical prostatectomy

Lymphadenectomy for prostate cancer (PC) is the most reliable procedure for detecting lymphatic metastases. The optimal extension of this procedure is still a topic of debate.

To analyse the diagnostic performance and complications of extended lymphadenectomy (ELD) and limited lymphadenectomy (LLD) in a series of patients with high-risk PC who underwent radical prostatectomy (RP).

A retrospective study was conducted on patients with high d'Amico risk who underwent RP with lymphadenectomy between 1999 and 2014. A comparative analysis was performed of the diagnostic capacity of lymphatic metastases of ELD and LLD and of postoperative complications at 90 days.

Ninety-three patients were analysed, 20 (21. 5%) and 73 (78. 5%) of whom underwent ELD and LLD, respectively. The mean age of the series was 65. 26 years (SD, 5. 51). The median follow-up was 1. 51 (0. 61-2. 29) years in the ELD group and 5. 94 (3. 61-9. 10) in the LLD group. The median number of nerve ganglia obtained was 13 (9-23) in the ELD group compared with 5 (2-8) in the LLD group (p

In our series, the detection of metastatic nerve ganglia was significantly greater with ELD. ELD increases the number of complications, with no differences compared with LLD in severity according to the modified Clavien scale.

Actas urologicas espanolas. 2015 Sep 07 [Epub ahead of print]

A Guijarro, L Reguero, V Hernández, J M de la Morena, E De la Peña, B López, B Fernández, C Parrilla, E Pérez-Fernández, I Alemany, C Llorente

Servicio Urología, Hospital Universitario Fundación Alcorcón, Madrid, España.  Servicio Urología, Hospital Universitario Fundación Alcorcón, Madrid, España. , Servicio Urología, Hospital Universitario Fundación Alcorcón, Madrid, España. , Servicio Urología, Hospital Universitario Fundación Alcorcón, Madrid, España. , Servicio Urología, Hospital Universitario Fundación Alcorcón, Madrid, España. , Servicio Urología, Hospital Universitario Fundación Alcorcón, Madrid, España. , Servicio Urología, Hospital Universitario Fundación Alcorcón, Madrid, España. , Servicio Urología, Hospital Universitario Fundación Alcorcón, Madrid, España. , Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Madrid, España. , Servicio Anatomía Patológica, Hospital Universitario Fundación Alcorcón, Madrid, España. , Servicio Urología, Hospital Universitario Fundación Alcorcón, Madrid, España.

PubMed

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