The Importance of Pelvic Lymph Node Dissection in Men With Clinically Localized Prostate Cancer

Reviews in Urology

H. Ballentine Carter¹  Mohamad E Allaf¹  Alan W Partin¹ 

[1] The James Buchanan Brady Urological Institute, Department of Urology, The Johns Hopkins Medical Institutions, Baltimore, MD

关键词: Prostate cancer;    Lymphadenectomy;    Clinical staging;    Magnetic resonance imaging;    Radioimmunoscintigraphy;    Nomograms;    Algorithms;   

DOI  :  

学科分类：基础医学

来源: MedReviews, LLC

【 摘 要 】

Despite advances in noninvasive staging, pelvic lymph node dissection (PLND) remains the most accurate means of detecting lymph node metastases in men with clinically localized prostate cancer. Nomograms exist that can identify patients at low risk for lymphatic metastases according to preoperative information. In general, it seems reasonable to omit PLND in men with a biopsy Gleason sum of 6 or less and a prostate-specific antigen level of 10 ng/mL or less. Ultimately, however, this decision should be made according to physician and patient preference, considering the low contemporary morbidity associated with PLND. When PLND is performed, studies suggest that an extended dissection maximizes the detection rate of nodal involvement. Retrospective data indicate that an extended dissection might play a therapeutic role in a subset of patients with a limited lymph node burden. However, this might be an artifact of stage migration, and prospective studies are needed to evaluate this further.

【 授权许可】

Unknown