Nodal counts during pelvic lymph node dissection for prostate cancer: An objective indicator of quality under the influence of very subjective factors Journal Article


Authors: Mazzola, C.; Savage, C.; Ahallal, Y.; Reuter, V. E.; Eastham, J. A.; Scardino, P. T.; Guillonneau, B.; Touijer, K. A.
Article Title: Nodal counts during pelvic lymph node dissection for prostate cancer: An objective indicator of quality under the influence of very subjective factors
Abstract: OBJECTIVE: • To examine the number of lymph nodes removed over time for men undergoing a standard pelvic lymph node dissection (PLND) during radical prostatectomy. PATIENTS AND METHODS: • In total, 2119 consecutive patients with clinically localized prostate cancer were scheduled for non-salvage radical prostatectomy between February 2005 and September 2009. • All patients underwent PLND, including the external iliac, hypogastric and obturator fossa nodal groups. • We tested whether the number of lymph nodes increased over time by including the date of each patient ' s surgery into a linear regression model using nonlinear terms. RESULTS: • From 2008 onward, there appears to be a large increase in the number of nodes removed. • Date of surgery was a signifi cant predictor of the number of nodes removed ( P < 0.001). • The anatomical template of dissection, the specimen submission and pathological assessment were reportedly unchanged. • The nodal yield increase in the later part of the study coincides with an increase in the academic interest in PLND and nodal metastasis in prostate cancer at the institutional level and worldwide. CONCLUSIONS: • Without any intentional change in surgical technique or pathological processing, the number of lymph nodes removed in our radical prostatectomy experience increased. • This change coincided with an increased academic interest in the subject and highlights the positive feedback effect. • The change also raises concerns about unaccounted for confounding factors that could affect multi-institutional datasets and surgical clinical trials. © 2011 The Authors BJU International © 2011 BJU International.
Keywords: pelvic lymph node dissection; radical prostatectomy; prostate neoplasm
Journal Title: BJU International
Volume: 109
Issue: 9
ISSN: 1464-4096
Publisher: Wiley Blackwell  
Date Published: 2012-05-01
Start Page: 1323
End Page: 1328
Language: English
DOI: 10.1111/j.1464-410X.2011.10610.x
PROVIDER: scopus
PUBMED: 21992661
DOI/URL:
Notes: --- - "Export Date: 1 May 2012" - "CODEN: BJINF" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Caroline Savage
    80 Savage
  2. Peter T Scardino
    621 Scardino
  3. Abdelkrim Karim Touijer
    190 Touijer
  4. James Eastham
    426 Eastham
  5. Clarisse Mazzola
    16 Mazzola
  6. Victor Reuter
    913 Reuter