Pelvic lymph node dissection during robot-assisted radical prostatectomy: Efficacy, limitations, and complications - A systematic review of the literature Journal Article
| Authors: | Ploussard, G.; Briganti, A.; De La Taille, A.; Haese, A.; Heidenreich, A.; Menon, M.; Sulser, T.; Tewari, A. K.; Eastham, J. A. |
| Article Title: | Pelvic lymph node dissection during robot-assisted radical prostatectomy: Efficacy, limitations, and complications - A systematic review of the literature |
| Abstract: | Context Pelvic lymph node dissection (PLND) in prostate cancer is the most effective method for detecting lymph node metastases. However, a decline in the rate of PLND during radical prostatectomy (RP) has been noted. This is likely the result of prostate cancer stage migration in the prostate-specific antigen-screening era, and the introduction of minimally invasive approaches such as robot-assisted radical prostatectomy (RARP). Objective To assess the efficacy, limitations, and complications of PLND during RARP. Evidence acquisition A review of the literature was performed using the Medline, Scopus, and Web of Science databases with no restriction of language from January 1990 to December 2012. The literature search used the following terms: prostate cancer, radical prostatectomy, robot-assisted, and lymph node dissection. Evidence synthesis The median value of nodal yield at PLND during RARP ranged from 3 to 24 nodes. As seen in open and laparoscopic RP series, the lymph node positivity rate increased with the extent of dissection during RARP. Overall, PLND-only related complications are rare. The most frequent complication after PLND is symptomatic pelvic lymphocele, with occurrence ranging from 0% to 8% of cases. The rate of PLND-associated grade 3-4 complications ranged from 0% to 5%. PLND is associated with increased operative time. Available data suggest equivalence of PLND between RARP and other surgical approaches in terms of nodal yield, node positivity, and intraoperative and postoperative complications. Conclusions PLND during RARP can be performed effectively and safely. The overall number of nodes removed, the likelihood of node positivity, and the types and rates of complications of PLND are similar to pure laparoscopic and open retropubic procedures. © 2013 European Association of Urology. Published by Elsevier B.V. All rights reserved. |
| Keywords: | cancer survival; treatment outcome; cancer surgery; review; cancer recurrence; patient selection; comparative study; cancer staging; nuclear magnetic resonance imaging; lymph node metastasis; lymph node dissection; pelvis lymph node; laparoscopy; lymphoscintigraphy; prospective study; prostate specific antigen; computer assisted tomography; deep vein thrombosis; surgical approach; retrospective study; prostate cancer; lung embolism; postoperative complication; gleason score; lymphedema; systematic review; prostatectomy; cancer specific survival; prostate biopsy; operation duration; urinary frequency; postoperative infection; pelvic lymph node dissection; radical prostatectomy; medical literature; clinical effectiveness; robotics; lymphatic drainage; ileus; leg edema; scrotal swelling; peroperative complication; lymphocele; ureter injury; bladder injury; robot assisted radical prostatectomy; postoperative edema; cancer prognosis; biochemical recurrence free survival; robot assisted; human; priority journal; anatomic landmark; cava vein disease |
| Journal Title: | European Urology |
| Volume: | 65 |
| Issue: | 1 |
| ISSN: | 0302-2838 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2014-01-01 |
| Start Page: | 7 |
| End Page: | 16 |
| Language: | English |
| DOI: | 10.1016/j.eururo.2013.03.057 |
| PROVIDER: | scopus |
| PUBMED: | 23582879 |
| DOI/URL: | |
| Notes: | Cited By (since 1996):1 -- Export Date: 2 January 2014 -- CODEN: EUURA -- Source: Scopus |
