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Annals of Surgical Oncology
Published in:

28-09-2024 | Magnetic Resonance Imaging | Urologic Oncology

Optimization of Extended Pelvic Lymph Node Dissection Side for Prostate Cancer

Authors: Masaki Shiota, MD, PhD, Masaki Shimbo, MD, PhD, Shigehiro Tsukahara, MD, PhD, Tokiyoshi Tanegashima, MD, PhD, Jun Mutaguchi, MD, PhD, Shunsuke Goto, MD, PhD, Satoshi Kobayashi, MD, PhD, Takashi Matsumoto, MD, PhD, Kazunori Hattori, MD, PhD, Fumiyasu Endo, MD, PhD, Masatoshi Eto, MD, PhD

Published in: Annals of Surgical Oncology | Issue 13/2024

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Abstract

Background

This study aimed to show the association between tumor location and laterality of positive lymph nodes by evaluating biopsy and magnetic resonance imaging (MRI) findings, and to optimize the extended pelvic lymph node dissection (ePLND) side for prostate cancer.

Methods

The study enrolled patients who underwent robot-assisted radical prostatectomy with ePLND. Tumor locations were determined according to International Society of Urological Pathology grade group 4/5 in biopsies and Prostate Imaging–Reporting and Data System category 4/5 in MRI results. The concordance of tumor location lobe and positive lymph node side with the performance of tumor location-guided ePLND for positive lymph node detection was evaluated.

Results

For 301 patients who underwent ePLND at Kyushu University Hospital, tumor locations determined by biopsy and MRI findings showed no lesion in 8 (2.7%) patients, unilateral lobe in 223 (74.1%) patients, and bilateral lobe in 70 (23.3%) patients. The accuracies for detection of any and all positive lymph nodes by tumor location-guided unilateral ePLND were 99.6% and 97.3%, respectively. Among the patients at St. Luke's International Hospital, the accuracies for detection of any and all positive lymph nodes by tumor location-guided unilateral ePLND were estimated to be 99.0% and 97.3%, respectively.

Conclusions

This study proposed tumor location-guided ePLND according to biopsy and MRI findings. This novel strategy is expected to reduce the burden of bilateral ePLND at the cost of acceptable risk of failing to detect positive lymph nodes.
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Metadata
Title
Optimization of Extended Pelvic Lymph Node Dissection Side for Prostate Cancer
Authors
Masaki Shiota, MD, PhD
Masaki Shimbo, MD, PhD
Shigehiro Tsukahara, MD, PhD
Tokiyoshi Tanegashima, MD, PhD
Jun Mutaguchi, MD, PhD
Shunsuke Goto, MD, PhD
Satoshi Kobayashi, MD, PhD
Takashi Matsumoto, MD, PhD
Kazunori Hattori, MD, PhD
Fumiyasu Endo, MD, PhD
Masatoshi Eto, MD, PhD
Publication date
28-09-2024
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 13/2024
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-024-16294-6

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