Izvorni znanstveni članak
https://doi.org/10.20471/acc.2018.57.s1.09
Unfavorable Clinicopathological Features in Radical Prostatectomy Patients Who Were Spared Pelvic Lymphadenectomy
Igor Tomašković
; Sestre milosrdnice University Hospital Center, Zagreb; Faculty of Medicine, J.J. Strossmayer University of Osijek; Scientific Center of Excellence for Reproductive and Regenerative Medicine
Sven Nikles
; Sestre milosrdnice University Hospital Center, Zagreb
Miroslav Tomić
; Sestre milosrdnice University Hospital Center, Zagreb; Scientific Center of Excellence for Reproductive and Regenerative Medicine
Ivan Pezelj
; Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Ivan Svaguša
; Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Matea Pirša
; Sestre milosrdnice University Hospital Center, Zagreb
Boris Ružić
; Sestre milosrdnice University Hospital Center, Zagreb; Scientific Center of Excellence for Reproductive and Regenerative Medicine
Sažetak
Pelvic lymph node dissection (PLND) during radical prostatectomy (RP) is the most accurate staging modality for lymph node assessment in patients with prostate cancer. It is recommended in all patients with intermediate or high-risk disease undergoing radical prostatectomy. The goal of our study was to assess unfavorable clinicopathological characteristics in patients with omitted lymphadenectomy (PLND) during radical prostatectomy based on the nomogram proposed by Briganti and colleagues. In 2011, 200 patients undertook radical prostatectomy in our institution. Among them 53 patients who fulfilled Briganti criteria and in whom we omitted lymphadenectomy based on current guidelines. Unfavorable clinicopathological features considered were: stage T3, positive surgical margins or biochemical relapse (BCR). We registered biopsy Gleason score 6 in 34 patients, and 19 patients had Gleason score 7. Stage pT2 was seen in 49 patients, and pT3 in 4. Gleason score after radical prostatectomy was upgraded from GS 6 to GS 7 in 20 patients (37%) and reduced in 1 patient (2%). After a median follow-up of 49 (44-56) months, there were 12 (22.6%) patients with BCR. Patients with biopsy Gleason score 6 (n=34) compared to biopsy Gleason 7 (n=19) patients showed no difference regarding positive margins (p=0.0738) and BCR (p=0,736) at 49 months follow-up. Thus, PLND according to current guidelines can be safely omitted in low-risk patients using Brigantinomogram.
Ključne riječi
Radical prostatectomy (RP); Pelvic lymph node dissection (PLND); Brigantinomogram; Adverse clinicopathological features
Hrčak ID:
207901
URI
Datum izdavanja:
1.10.2018.
Posjeta: 1.651 *