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PELVIC LYMPHADENECTOMY IN THE PROSTATE CARCINOMA AND ITS LIMITS


Authors: MUDr. Michal Staník
Authors‘ workplace: Urologická klinika LF MU a FN Brno pracoviště Bohunice
Published in: Urol List 2006; 4(4): 14-18

Overview

The article provides an overview of current knowledge of the indications for, and the extent and benefit of pelvic lymphadenectomy in prostate cancer. With the onset of PSA screening, the rate of lymph node metastases in radical prostatectomy has sharply declined. Some recent studies indicate that the reported results may be underrated due to a limited extent of pelvic lymphadenectomy. By extending lymphadenectomy to internal iliac lymph nodes more lymph node metastases could be obtained, and available data indicate that the procedure can improve the prognosis of the patient. However, there is still controversy as to the indication of lymphadenectomy, as the majority of patients do not need it. New nomograms based on data from extended lymphadenectomy have been developed to better predict the probability of lymph node metastases. The concept of the sentinel lymph node dissection appears to be an alternative to limited pelvic lymphadenectomy. If the sentinel node is free of tumour cells, further metastases can be excluded and performing extended lymphadenectomy becomes unnecessary.

KEY WORDS:
prostate cancer, radical prostatectomy, limited and extended pelvic, lymphadenectomy, lymph node metastases


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