Can pelvic node dissection at radical prostatectomy influence the nodal recurrence at salvage lymphadenectomy for prostate cancer? Journal Article


Authors: Sivaraman, A.; Benfante, N.; Touijer, K.; Coleman, J.; Scardino, P.; Laudone, V.; Eastham, J.
Article Title: Can pelvic node dissection at radical prostatectomy influence the nodal recurrence at salvage lymphadenectomy for prostate cancer?
Abstract: Purpose: To verify the quality of pelvic lymph node dissection (PLND) performed at radical prostatectomy (RP) and its impact on nodal recurrence in patients undergoing salvage lymph node dissection (sLND). Materials and Methods: Retrospective review of 48 patients who underwent sLND for presumed nodal recurrence, to describe the PLND characteristics at RP and correlate the anatomical sites and number of suspicious nodes reported in radiological imaging and final pathology of sLND. Results: Overall, at RP, 8 (16.7%) did not undergo PLND, 32 (66.7%) and 8 (16.7%) received a “limited” (between external iliac vein and obturator nerve) and an “extended” (external iliac, hypogastric, and obturator) dissection, respectively. Median nodes removed during limited and extended dissection were 2 and 24, respectively. At sLND, the mean age was 61.3 years and median prostate specific antigen (PSA) was 1.07 ng/mL. Median nodes removed at sLND were 17 with a median of 2 positive nodes. Recurrent nodes were identified within the template of an extended PLND in 62.5%, 50.0% and 12.5% patients, respectively, following prior no, limited and extended dissection at RP. Recurrence outside the expected lymphatic drainage pathway was noted in 37.5% patients with prior extended dissection at RP. There was a correlation between imaging and pathology specimen in 83% for node location and 58.3% for number of anatomical sites involved. Conclusions: In prostate cancer patients undergoing sLND, most had inadequate PLND at the original RP. Pattern of nodal recurrence may be influenced by the prior dissection and pre sLND imaging appears to underestimate the nodal recurrence. © The Korean Urological Association.
Keywords: salvage therapy; lymph node excision; recurrence; prostatic neoplasms; local; neoplasm recurrence
Journal Title: Investigative and Clinical Urology
Volume: 59
Issue: 2
ISSN: 2466-0493
Publisher: Korean Urological Association  
Date Published: 2018-03-01
Start Page: 83
End Page: 90
Language: English
DOI: 10.4111/icu.2018.59.2.83
PROVIDER: scopus
PMCID: PMC5840122
PUBMED: 29520383
DOI/URL:
Notes: Article -- Export Date: 2 April 2018 -- Source: Scopus
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MSK Authors
  1. Jonathan Coleman
    181 Coleman
  2. Vincent Laudone
    59 Laudone
  3. Peter T Scardino
    615 Scardino
  4. Abdelkrim Karim Touijer
    190 Touijer
  5. James Eastham
    422 Eastham