Surgery Medical News about Pelvic lymphadenectomy, Prostate cancer, Robot-assisted radical prostatectomy

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Comparison of open and robot-assisted pelvic lymphadenectomy for prostate cancer
Journal of Endourology, 07/10/09

Polcari AJ et al. – Study demonstrates that the lymph node yield obtained during robot-assisted pelvic lymphadenectomy for prostate cancer is comparable to an open approach using a similar template. An open extended node dissection yields more nodes and identifies a greater number of patients with lymph node involvement.

Methods

An evaluation of whether there are differences in the lymph node yield and incidence of nodal metastasis among pts undergoing:
- Robot-assisted radical prostatectomy with pelvic lymphadenectomy (LAD) and
- Open radical retropubic prostatectomy with either a standard or extended node dissection
Pts in group 1 (n=60) underwent robot-assisted standard LAD
Those in group 2 (n=64) had open standard LAD
Pts in group 3 (n=43) were treated with open extended LAD
Statistical comparison was made between the 3 groups stratified by histologic grade and pathologic stage

Results

Mean lymph node yield was 8.2 for group 1, 7.6 for group 2, and 14.8 for group 3
Overall incidence of positive nodes in each group was 3.3%, 1.6%, and 18.6%, respectively
No differences between the node counts and probability of finding positive nodes between the robot-assisted and open standard dissections
Extended LAD identified pts with positive nodes at a greater frequency, although those pts were more likely to have adverse pathologic features
Complications related to the lymphadenectomy were not different between the groups

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