Acta clinica Croatica, Vol. 44 No. 1, 2005.
Professional paper
Lymph Node Frozen Section Analysis during Radical Prostatectomy
Božo Krušlin
Stela Bulimbašić
Hrvoje Čupić
Ante Reljić
Davor Tomas
Igor Tomašković
Ognjen Kraus
Mladen Belicza
Abstract
Radical prostatectomy is a treatment of choice for localized prostatic adenocarcinoma. In most cases, radical prostatectomy is combined with pelvic lymph node dissection. During the last decade, the necessity to perform lymphadenectomy in all patients has been questioned. Lymph node dissection adds the risk of complications, and increases operation time and medical costs. Data of patients with prostatic adenocarcinoma who underwent radical prostatectomy at Department of Urology, Sestre milosrdnice University Hospital, Zagreb during the period from January 1, 1998 till December 31, 2002, were analyzed. There were 110 patients who had complete preoperative data including prostate-specific antigen (PSA)
value, Gleason score, T stage and lymph node status on frozen section analysis. Using predictive nomograms the patients were divided into different risk groups. Positive lymph node(s) were found in one patient with T2 and in five patients with T3, whereby three, two and one of these patients had Gleason score 6, 7 and 8, respectively. There was a correlation between increasing PSA value and positive lymph nodes (p<0.005). A statistically significant correlation between T stage and PSA value (p<0.005) as well as between T stage and Gleason score (p=0.0014) was also observed. The majority of patients belonged to low and intermediate risk groups, known to benefit very little from lymph node dissection and frozen section analysis. Thus, it seems reasonable to reconsider the use of these predictive nomograms on advising and therapy strategy planning for newly diagnosed patients, especially those with clinically organ-confined disease.
Keywords
Prostatic neoplasms - pathology; Prostatic neoplasms - surgery; Lymp node excision; Lymp node - pathology; Frozen sections
Hrčak ID:
14232
URI
Publication date:
3.3.2005.
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