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Radioisotope guided sentinel lymph node dissection in patients with localized prostate cancer: Results of the first 100 cases
European Journal of Surgical Oncology, 06/04/09

Bastide C et al. - Limited pelvic lymph node dissection (PLND) to obturator fossa is clearly insufficient for accurate lymph node staging in patients with prostate cancer (PCa). Sentinel lymph node (SLN) procedure could be an alternative with an excellent sensitivity in patients with unfavorable prognostic factors.

• An assessment of the results and the relevance of radioisotope guided PLND in loco-regional staging in pts with clinically localized PCa
• 100 pts underwent radioisotope guided PLND
• 87 pts were candidates for retropubic radical prostatectomy and 13 underwent radiotherapy
• 72 first pts received 2× 0.3 ml of 30 MBq-nanocolloid-^99mTc
• Next 28 received 2× 0.3 ml of 100 MBq
• SLNs were detected intraoperatively with a gamma probe

• Median number of 3 SLNs was removed per patient
• SLNs were located outside obturator fossa in >2/3^rd of pts
• Lymph node involvement was observed in 12% of pts
• 50% of lymph node metastases (LNM) were outside obturator fossa
• 41.6% of LNM were lying at the first centimeters of the hypogastric artery
• 11/13 LNM were detected in the SLN
• 2 non-SLN (NSLN) involved nodes were found in 2 pts who failed the sentinel lymph node procedure
• Each of 12 pts had pre-operative PSA above 10 ng/ml and Gleason score ≥7

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