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Erschienen in: World Journal of Urology 1/2007

01.03.2007 | Topic Paper

Role of lymphadenectomy in clinically organ-confined prostate cancer

verfasst von: Nivedita Bhatta Dhar, Fiona C. Burkhard, Urs E. Studer

Erschienen in: World Journal of Urology | Ausgabe 1/2007

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Abstract

There has been considerable debate about the utility of pelvic lymph node dissection (PLND) when performing a radical prostatectomy. Reported practices vary from those who always perform an extended PLND to those who employ a predictive nomogram in their decision making to those who are increasingly not performing a PLND in low-risk disease. A Medline search was used to identify relevant manuscripts dealing with the role of lymphadenectomy in clinically organ-confined prostate cancer. A greater number of lymph nodes (LN) removed and examined at prostatectomy for prostate cancer appears to increase the likelihood of finding LN metastases and increase prostate cancer-specific survival even in patients who have histologically uninvolved LN. This survival benefit may result from more accurate staging and possible removal of occult metastases. The need for and extent of PLND in prostate cancer, especially in low-risk disease, however, is unlikely.
Literatur
1.
Zurück zum Zitat Danella JF, deKernion JB, Smith RB et al (1993) The contemporary incidence of lymph node metastases in prostate cancer: implications for laparoscopic lymph node dissection. J Urol 149:1488–1491PubMed Danella JF, deKernion JB, Smith RB et al (1993) The contemporary incidence of lymph node metastases in prostate cancer: implications for laparoscopic lymph node dissection. J Urol 149:1488–1491PubMed
2.
Zurück zum Zitat Petros JA, Catalona WJ (1992) Lower incidence of unsuspected lymph node metastasis in 512 consecutive patients with clinically localized prostate cancer. J Urol 147:1574–1575PubMed Petros JA, Catalona WJ (1992) Lower incidence of unsuspected lymph node metastasis in 512 consecutive patients with clinically localized prostate cancer. J Urol 147:1574–1575PubMed
3.
Zurück zum Zitat Gervasi LA, Mata J, Easley JD et al (1989) Prognostic significance of lymph nodal metastases in prostate cancer. J Urol 142:332–336PubMed Gervasi LA, Mata J, Easley JD et al (1989) Prognostic significance of lymph nodal metastases in prostate cancer. J Urol 142:332–336PubMed
4.
Zurück zum Zitat Partin AW, Mangold LA, Lamm DM, Walsh PC, Epstein JI, Pearson JD (2001) Contemporary update of prostate cancer staging nomograms (Partin tables) for the new millennium. Urology 58(6):843–848PubMedCrossRef Partin AW, Mangold LA, Lamm DM, Walsh PC, Epstein JI, Pearson JD (2001) Contemporary update of prostate cancer staging nomograms (Partin tables) for the new millennium. Urology 58(6):843–848PubMedCrossRef
5.
Zurück zum Zitat Narayan P, Fournier G, Gajendran V et al (1994) Utility of preoperative serum prostate specific antigen concentration and biopsy Gleason score in predicting risk of pelvic lymph node metastases in prostate cancer. Urology 44:519–524PubMedCrossRef Narayan P, Fournier G, Gajendran V et al (1994) Utility of preoperative serum prostate specific antigen concentration and biopsy Gleason score in predicting risk of pelvic lymph node metastases in prostate cancer. Urology 44:519–524PubMedCrossRef
6.
Zurück zum Zitat Bluestein DL, Bostwick DG, Bergstralh EJ et al (1994) Eliminating the need for bilateral pelvic lymphadenectomy in select patients with prostate cancer. J Urol 151:1315–1320PubMed Bluestein DL, Bostwick DG, Bergstralh EJ et al (1994) Eliminating the need for bilateral pelvic lymphadenectomy in select patients with prostate cancer. J Urol 151:1315–1320PubMed
7.
Zurück zum Zitat Partin AW, Kattan MW, Subong EN et al (1997) Combination of prostate-specific antigen, clinical stage, and Gleason score to predict pathological stage of localized prostate cancer. A multi-institutional update. JAMA 277:1445–1451 Partin AW, Kattan MW, Subong EN et al (1997) Combination of prostate-specific antigen, clinical stage, and Gleason score to predict pathological stage of localized prostate cancer. A multi-institutional update. JAMA 277:1445–1451
8.
Zurück zum Zitat Cagiannos I, Karakiewicz P, Eastham JA et al (2003) A preoperative nomogram identifying decreased risk of positive pelvic lymph nodes in patients with prostate cancer. J Urol 170(5):1798–1803PubMedCrossRef Cagiannos I, Karakiewicz P, Eastham JA et al (2003) A preoperative nomogram identifying decreased risk of positive pelvic lymph nodes in patients with prostate cancer. J Urol 170(5):1798–1803PubMedCrossRef
9.
Zurück zum Zitat Augustin H, Eggert T, Wenske S et al (2004) Comparison of accuracy between the Partin tables of 1997 and 2001 to predict final pathological stage in clinically localized prostate cancer. J Urol 171:177–181PubMedCrossRef Augustin H, Eggert T, Wenske S et al (2004) Comparison of accuracy between the Partin tables of 1997 and 2001 to predict final pathological stage in clinically localized prostate cancer. J Urol 171:177–181PubMedCrossRef
10.
Zurück zum Zitat Wolf JS Jr, Cher M, Dall’era M, Presti JC Jr, Hricak H, Carroll PR (1995) The use and accuracy of cross-sectional imaging and fine needle aspiration cytology for detection of pelvic lymph node metastases before radical prostatectomy. J Urol 153(3 Pt 2):993–999; review Wolf JS Jr, Cher M, Dall’era M, Presti JC Jr, Hricak H, Carroll PR (1995) The use and accuracy of cross-sectional imaging and fine needle aspiration cytology for detection of pelvic lymph node metastases before radical prostatectomy. J Urol 153(3 Pt 2):993–999; review
11.
12.
13.
Zurück zum Zitat Wawroschek F, Vogt H, Weckermann D, Wagner T, Hamm M, Harzmann R (2001) Radioisotope guided pelvic lymph node dissection for prostate cancer. J Urol 166:1715PubMedCrossRef Wawroschek F, Vogt H, Weckermann D, Wagner T, Hamm M, Harzmann R (2001) Radioisotope guided pelvic lymph node dissection for prostate cancer. J Urol 166:1715PubMedCrossRef
14.
Zurück zum Zitat Weckermann D, Dorn R, Holl G, Wagner T, Harzmann R (2006) Limitations of radioguided surgery in high-risk prostate cancer. Eur Urol 11 Sep 2006 (epub ahead of print) Weckermann D, Dorn R, Holl G, Wagner T, Harzmann R (2006) Limitations of radioguided surgery in high-risk prostate cancer. Eur Urol 11 Sep 2006 (epub ahead of print)
15.
Zurück zum Zitat Borley N, Fabrin K, Sriprasad S et al (2003) Laparoscopic pelvic lymph node dissection allows significantly more accurate staging in “high-risk” prostate cancer compared to MRI or CT. Scand J Urol Nephrol 37:382–386PubMedCrossRef Borley N, Fabrin K, Sriprasad S et al (2003) Laparoscopic pelvic lymph node dissection allows significantly more accurate staging in “high-risk” prostate cancer compared to MRI or CT. Scand J Urol Nephrol 37:382–386PubMedCrossRef
16.
Zurück zum Zitat Mattei A et al (2006) Anatomic localization of prostatic sentinel lymph nodes (SLN) according to fusion imaging of SPECT and CT scans after intraprostatic injection of Technetium-99m-Nanocolloid. J Urol 175(S4):448, Abstract 1388 Mattei A et al (2006) Anatomic localization of prostatic sentinel lymph nodes (SLN) according to fusion imaging of SPECT and CT scans after intraprostatic injection of Technetium-99m-Nanocolloid. J Urol 175(S4):448, Abstract 1388
17.
Zurück zum Zitat Harisinghani MG, Barentsz J, Hahn PF et al (2003) Noninvasive detection of clinically occult lymph-node metastases in prostate cancer. N Engl J Med 348:2491–2499PubMedCrossRef Harisinghani MG, Barentsz J, Hahn PF et al (2003) Noninvasive detection of clinically occult lymph-node metastases in prostate cancer. N Engl J Med 348:2491–2499PubMedCrossRef
18.
Zurück zum Zitat Troyer JK, Beckett ML, Wright GL Jr (1997) Location of prostate-specific membrane antigen in the LN CaP prostate carcinoma cell line. Prostate 30:232–242PubMedCrossRef Troyer JK, Beckett ML, Wright GL Jr (1997) Location of prostate-specific membrane antigen in the LN CaP prostate carcinoma cell line. Prostate 30:232–242PubMedCrossRef
19.
Zurück zum Zitat Katz AE, Olsson CA, Raffo AJ et al (1994) Molecular staging of prostate cancer with the use of an enhanced reverse transcriptase-PCR assay. Urology 43:765–775PubMedCrossRef Katz AE, Olsson CA, Raffo AJ et al (1994) Molecular staging of prostate cancer with the use of an enhanced reverse transcriptase-PCR assay. Urology 43:765–775PubMedCrossRef
20.
Zurück zum Zitat Briganti A, Chun FK, Salonia A, Gallina A, Farina E, Da Pozzo LF, Rigatti P, Montorsi F, Karakiewicz PI (2006) Validation of a nomogram predicting the probability of lymph node invasion based on the extent of pelvic lymphadenectomy in patients with clinically localized prostate cancer. BJU Int 98(4):788–793PubMedCrossRef Briganti A, Chun FK, Salonia A, Gallina A, Farina E, Da Pozzo LF, Rigatti P, Montorsi F, Karakiewicz PI (2006) Validation of a nomogram predicting the probability of lymph node invasion based on the extent of pelvic lymphadenectomy in patients with clinically localized prostate cancer. BJU Int 98(4):788–793PubMedCrossRef
21.
Zurück zum Zitat Weingartner A, Ramaswamy A, Bittinger A et al (1996) Anatomical basis for pelvic lymphadenectomy in prostate cancer results of an autopsy study and implications for the clinic. J Urol 156:1969–1971PubMedCrossRef Weingartner A, Ramaswamy A, Bittinger A et al (1996) Anatomical basis for pelvic lymphadenectomy in prostate cancer results of an autopsy study and implications for the clinic. J Urol 156:1969–1971PubMedCrossRef
22.
Zurück zum Zitat Messing EM, Manola J, Yao J, Kiernan M, Crawford D, Wilding G, di’SantAgnese PA, Trump D; Eastern Cooperative Oncology Group study EST 3886 (2006) Immediate versus deferred androgen deprivation treatment in patients with node-positive prostate cancer after radical prostatectomy and pelvic lymphadenectomy. Lancet Oncol 7(6):472–479 Messing EM, Manola J, Yao J, Kiernan M, Crawford D, Wilding G, di’SantAgnese PA, Trump D; Eastern Cooperative Oncology Group study EST 3886 (2006) Immediate versus deferred androgen deprivation treatment in patients with node-positive prostate cancer after radical prostatectomy and pelvic lymphadenectomy. Lancet Oncol 7(6):472–479
23.
Zurück zum Zitat Heidenreich A, Varga Z, von Knobloch R (2002) Extended pelvic lymphadenectomy in patients undergoing radical prostatectomy: high incidence of lymph node metastasis. J Urol 167:1681–1684PubMedCrossRef Heidenreich A, Varga Z, von Knobloch R (2002) Extended pelvic lymphadenectomy in patients undergoing radical prostatectomy: high incidence of lymph node metastasis. J Urol 167:1681–1684PubMedCrossRef
24.
Zurück zum Zitat Bader P, Burkhard FC, Markwalder R, Studer UE (2002) Is a limited lymph node dissection an adequate staging procedure for prostate cancer? J Urol 168:514–518PubMedCrossRef Bader P, Burkhard FC, Markwalder R, Studer UE (2002) Is a limited lymph node dissection an adequate staging procedure for prostate cancer? J Urol 168:514–518PubMedCrossRef
25.
Zurück zum Zitat Stone NN, Stock RG, Unger P (1997) Laparoscopic pelvic lymph node dissection for prostate cancer: comparison to the extended and modified techniques. J Urol 158:1891–1894PubMedCrossRef Stone NN, Stock RG, Unger P (1997) Laparoscopic pelvic lymph node dissection for prostate cancer: comparison to the extended and modified techniques. J Urol 158:1891–1894PubMedCrossRef
26.
Zurück zum Zitat Clark T, Parekh DJ, Cookson MS et al (2003) Randomized prospective evaluation of extended versus limited lymph node dissection in patients with clinically localized prostate cancer. J Urol 169:145–148PubMedCrossRef Clark T, Parekh DJ, Cookson MS et al (2003) Randomized prospective evaluation of extended versus limited lymph node dissection in patients with clinically localized prostate cancer. J Urol 169:145–148PubMedCrossRef
27.
Zurück zum Zitat Aus G, Abbou CC, Bolla M et al (2005) EAU guidelines on prostate cancer. Eur Urol 48:546–551PubMedCrossRef Aus G, Abbou CC, Bolla M et al (2005) EAU guidelines on prostate cancer. Eur Urol 48:546–551PubMedCrossRef
28.
Zurück zum Zitat Golimbu M, Provet J, Al-Askari S, Morales P (1987) Radical prostatectomy for stage D1 prostate cancer. Prognostic variables and results of treatment. Urology 30:427–435PubMedCrossRef Golimbu M, Provet J, Al-Askari S, Morales P (1987) Radical prostatectomy for stage D1 prostate cancer. Prognostic variables and results of treatment. Urology 30:427–435PubMedCrossRef
29.
Zurück zum Zitat Catalona WJ, Miller DR, Kavoussi LR (1988) Intermediate-term survival results in clinically understaged prostate cancer patients following radical prostatectomy. J Urol 140:540–543PubMed Catalona WJ, Miller DR, Kavoussi LR (1988) Intermediate-term survival results in clinically understaged prostate cancer patients following radical prostatectomy. J Urol 140:540–543PubMed
30.
Zurück zum Zitat Pound CR, Partin AW, Eisenberger MA, Chan DW, Pearson JD, Walsh PC (1999) Natural history of progression after PSA elevation following radical prostatectomy. JAMA 281(17):1591–1597PubMedCrossRef Pound CR, Partin AW, Eisenberger MA, Chan DW, Pearson JD, Walsh PC (1999) Natural history of progression after PSA elevation following radical prostatectomy. JAMA 281(17):1591–1597PubMedCrossRef
31.
Zurück zum Zitat Bader P, Burkhard FC, Markwalder R, Studer UE (2003) Disease progression and survival of patients with positive lymph nodes after radical prostatectomy. Is there a chance of cure? J Urol 169:849–854PubMedCrossRef Bader P, Burkhard FC, Markwalder R, Studer UE (2003) Disease progression and survival of patients with positive lymph nodes after radical prostatectomy. Is there a chance of cure? J Urol 169:849–854PubMedCrossRef
32.
Zurück zum Zitat Daneshmand S, Quek ML, Stein JP, Lieskovsky G, Cai J, Pinski J, Skinner EC, Skinner DG (2004) Prognosis of patients with lymph node positive prostate cancer following radical prostatectomy: long-term results. J Urol 172(6 Pt 1):2252–2255PubMedCrossRef Daneshmand S, Quek ML, Stein JP, Lieskovsky G, Cai J, Pinski J, Skinner EC, Skinner DG (2004) Prognosis of patients with lymph node positive prostate cancer following radical prostatectomy: long-term results. J Urol 172(6 Pt 1):2252–2255PubMedCrossRef
33.
Zurück zum Zitat Allaf ME, Palapattu GS, Trock BJ, Carter HB, Walsh PC (2004) Anatomical extent of lymph node dissection: impact on men with clinically localized prostate cancer J Urol 175(85 Pt 1):1840–1844CrossRef Allaf ME, Palapattu GS, Trock BJ, Carter HB, Walsh PC (2004) Anatomical extent of lymph node dissection: impact on men with clinically localized prostate cancer J Urol 175(85 Pt 1):1840–1844CrossRef
34.
Zurück zum Zitat Bader P, Spahn M, Huber R, Echtle D, Frohneberg D (2004) Limited lymph node dissection in prostate cancer may miss lymph node metastases and determines outcome of apparently pN0 prostate cancer. Eur Urol 3(Suppl):16; abstract no. 55 Bader P, Spahn M, Huber R, Echtle D, Frohneberg D (2004) Limited lymph node dissection in prostate cancer may miss lymph node metastases and determines outcome of apparently pN0 prostate cancer. Eur Urol 3(Suppl):16; abstract no. 55
35.
Zurück zum Zitat Joslyn S, Konety B (2006) Impact of extent of lymphadenectomy on survival after radical prostatectomy for prostate cancer. Urology 68(1):121–125PubMedCrossRef Joslyn S, Konety B (2006) Impact of extent of lymphadenectomy on survival after radical prostatectomy for prostate cancer. Urology 68(1):121–125PubMedCrossRef
36.
Zurück zum Zitat Masterson TA, Bianco FJ Jr, Vickers AJ, DiBlasio CJ, Fearn PA, Rabbani F, Eastham JA, Scardino PT (2006) The association between total and positive lymph node counts, and disease progression in clinically localized prostate cancer. J Urol 175(4):1320–1324; discussion 1324–1325 Masterson TA, Bianco FJ Jr, Vickers AJ, DiBlasio CJ, Fearn PA, Rabbani F, Eastham JA, Scardino PT (2006) The association between total and positive lymph node counts, and disease progression in clinically localized prostate cancer. J Urol 175(4):1320–1324; discussion 1324–1325
37.
Zurück zum Zitat Ferrari AC, Stone NN, Kurek R et al (2006) Molecular load of pathologically occult metastases in pelvic lymph nodes is an independent prognostic marker of biochemical failure after localized prostate cancer treatment. J Clin Oncol 24(19):3081–3088PubMedCrossRef Ferrari AC, Stone NN, Kurek R et al (2006) Molecular load of pathologically occult metastases in pelvic lymph nodes is an independent prognostic marker of biochemical failure after localized prostate cancer treatment. J Clin Oncol 24(19):3081–3088PubMedCrossRef
38.
Zurück zum Zitat Serni S, Masieri L, Minervini A, Lapini A, Nesi G, Carini M (2006) Cancer progression after anterograde radical prostatectomy for pathologic Gleason score 8 to 10 and influence of concomitant variables. Urology 67:373–378PubMedCrossRef Serni S, Masieri L, Minervini A, Lapini A, Nesi G, Carini M (2006) Cancer progression after anterograde radical prostatectomy for pathologic Gleason score 8 to 10 and influence of concomitant variables. Urology 67:373–378PubMedCrossRef
39.
Zurück zum Zitat Feinstein AR, Sosin DM, Wells CK (1985) The Will Rogers phenomenon. Stage migration and new diagnostic techniques as a source of misleading statistics for survival in cancer. N Engl J Med 312:1604–1608PubMedCrossRef Feinstein AR, Sosin DM, Wells CK (1985) The Will Rogers phenomenon. Stage migration and new diagnostic techniques as a source of misleading statistics for survival in cancer. N Engl J Med 312:1604–1608PubMedCrossRef
40.
Zurück zum Zitat DiMarco DS, Zincke H, Sebo TJ, Slezak J, Bergstralh EJ, Blute ML (2005) The extent of lymphadenectomy for pTXNO prostate cancer does not affect prostate cancer outcome in the prostate specific antigen era. J Urol 173(4):1121–1125PubMedCrossRef DiMarco DS, Zincke H, Sebo TJ, Slezak J, Bergstralh EJ, Blute ML (2005) The extent of lymphadenectomy for pTXNO prostate cancer does not affect prostate cancer outcome in the prostate specific antigen era. J Urol 173(4):1121–1125PubMedCrossRef
41.
Zurück zum Zitat Schumacher M, Burkhard F, Thalmann G, Fleischmann A, Studer U. Is pelvic lymph node dissection necessary in patients with a serum PSA<10 ng/ml undergoing radical prostatectomy for prostate cancer? Euro Urol 50(2):272–279 Schumacher M, Burkhard F, Thalmann G, Fleischmann A, Studer U. Is pelvic lymph node dissection necessary in patients with a serum PSA<10 ng/ml undergoing radical prostatectomy for prostate cancer? Euro Urol 50(2):272–279
42.
Zurück zum Zitat Grossfeld GD, Chang JJ, Broering JM, Li Y, Lubeck DP, Flanders SC et al (2001) Under staging and under grading in a contemporary series of patients undergoing radical prostatectomy: results from the cancer of the prostate strategic urologic research endeavour database. J Urol 165:851–856PubMedCrossRef Grossfeld GD, Chang JJ, Broering JM, Li Y, Lubeck DP, Flanders SC et al (2001) Under staging and under grading in a contemporary series of patients undergoing radical prostatectomy: results from the cancer of the prostate strategic urologic research endeavour database. J Urol 165:851–856PubMedCrossRef
43.
Zurück zum Zitat Campbell SC, Klein EA, Levin HS, Piedmonte MR (1995) Open pelvic lymph node dissection for prostate cancer: a reassessment. Urology 46:352–355PubMedCrossRef Campbell SC, Klein EA, Levin HS, Piedmonte MR (1995) Open pelvic lymph node dissection for prostate cancer: a reassessment. Urology 46:352–355PubMedCrossRef
Metadaten
Titel
Role of lymphadenectomy in clinically organ-confined prostate cancer
verfasst von
Nivedita Bhatta Dhar
Fiona C. Burkhard
Urs E. Studer
Publikationsdatum
01.03.2007
Verlag
Springer-Verlag
Erschienen in
World Journal of Urology / Ausgabe 1/2007
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-007-0149-8

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