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Can sentinel pelvic lymph node dissection replace extended pelvic lymph node dissection in patients with prostate cancer?

Nature Clinical Practice Urology volume 4, pages 636–637 (2007)Cite this article

Sentinel pelvic lymph node dissection is a radioisotope-guided technique that has been developed for the detection of potential lymph node metastases. In this Viewpoint, Professor Janetschek discusses the possibility that sentinel pelvic lymph node dissection could replace extended pelvic lymph node dissection in patients with prostate cancer.

Several authors have doubted the benefit of an extended PLND approach, and continue to perform PLND limited to the obturator fossa.3 Extended PLND is a time-consuming procedure. A prospective study has also shown that the complication rate in patients who undergo extended PLND is higher than in patients who undergo limited PLND;4 however, another study has shown that the complication rate for patients undergoing extended PLND can be as low as 2.1%.1 Despite the knowledge that the extent of PLND is positively correlated with LNM yield, no definitive proof shows that the extent of PLND influences survival; therefore, the template that is most appropriate for optimizing the yield of LNM, increasing cancer-specific survival and decreasing surgery-related complications, remains a matter of debate. A method that identifies LNM, or the nodes at risk of metastases, prior to or during surgery is urgently needed.

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References

  1. Bader P et al. (2002) Is a limited lymph node dissection an adequate staging procedure for prostate cancer? J Urol 168: 514–518

    Article  Google Scholar 

  2. Wawroschek F et al. (2001) Radioisotope guided pelvic lymph node dissection for prostate cancer. J Urol 166: 1715–1719

    Article  CAS  Google Scholar 

  3. DiMarco DS et al. (2005) The extent of lymphadenectomy for pTXNO prostate cancer does not affect prostate cancer outcome in the prostate specific antigen era. J Urol 173: 1121–1125

    Article  Google Scholar 

  4. Clark T et al. (2003) Randomized prospective evaluation of extended versus limited lymph node dissection in patients with clinically localized prostate cancer. J Urol 169: 145–147

    Article  Google Scholar 

  5. Leijte JA et al. (2007) Reliability and safety of current dynamic sentinel node biopsy for penile carcinoma. Eur Urol 52: 170–177

    Article  Google Scholar 

  6. Jeschke S et al. (2005) Detection of early lymph node metastases in prostate cancer by laparoscopic radioisotope guided sentinel lymph node dissection. J Urol 173: 1943–1946

    Article  Google Scholar 

  7. Warncke SH et al. (2007) Detection rate and operating time required for gamma probe-guided sentinel lymph node resection after injection of technetium-99m nanocolloid into the prostate with and without preoperative imaging. Eur Urol 52: 126–132

    Article  Google Scholar 

  8. Weckermann D et al. (2007) Limitations of radioguided surgery in high-risk prostate cancer. Eur Urol 51: 1549–1556

    Article  Google Scholar 

  9. Weckermann D et al. (2007) Sentinel lymph node dissection for prostate cancer: experience with more than 1,000 patients. J Urol 177: 916–920

    Article  Google Scholar 

  10. Jeschke S et al. (2007) Laparoscopic Radioisotope-Guided Sentinel Lymph Node Dissection in Staging of Prostate Cancer. Eur Urol [10.1016/j.eururo.2007.03.064]

  11. Fukuda M et al. (2007) Detection of sentinel node micrometastasis by step section and immunohistochemistry in patients with prostate cancer. J Urol 177: 1313–1317

    Article  Google Scholar 

Download references

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  1. Department of Urology, Elisabethinen Hospital, Fadingerstraße 1, 4010 Linz, Austria guenter.janetschek@elisabethinen.or.at

Authors and Affiliations

  1. G Janetschek is a Professor of Urology at the Department of Urology, Elisabethinen Hospital, Linz, Austria.,

    Günter Janetschek

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  1. Günter Janetschek
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Janetschek, G. Can sentinel pelvic lymph node dissection replace extended pelvic lymph node dissection in patients with prostate cancer?. Nat Rev Urol 4, 636–637 (2007). https://doi.org/10.1038/ncpuro0942

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