Reconsidering the role of pelvic lymph node dissection with radical prostatectomy for prostate cancer in an era of improving radiological staging techniques.
Identifieur interne : 000466 ( PubMed/Checkpoint ); précédent : 000465; suivant : 000467Reconsidering the role of pelvic lymph node dissection with radical prostatectomy for prostate cancer in an era of improving radiological staging techniques.
Auteurs : J W Yaxley [Australie] ; J. Dagher [Australie] ; B. Delahunt [Nouvelle-Zélande] ; L. Egevad [Suède] ; J. Srigley [Canada] ; H. Samaratunga [Australie]Source :
- World journal of urology [ 1433-8726 ] ; 2017.
Abstract
Performing an extended pelvic lymph node dissection (PLND) on all men with intermediate- and high-risk prostate cancer at the time of a radical prostatectomy (RP) remains controversial. The majority of patients PLND histology is benign, and the long-term cancer-free progression in men with positive lymph node metastasis is low. The objective is to investigate the probability of long-term biochemical freedom from recurrent disease (bNED) in men with lymph node metastasis identified at the time of radical prostatectomy (RP).
DOI: 10.1007/s00345-017-2119-0
PubMed: 29116393
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Dagher</name><affiliation wicri:level="1"><nlm:affiliation>Aquesta Uro-pathology, University of Queensland, Brisbane, QLD, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Aquesta Uro-pathology, University of Queensland, Brisbane, QLD</wicri:regionArea><wicri:noRegion>QLD</wicri:noRegion></affiliation></author><author><name sortKey="Delahunt, B" sort="Delahunt, B" uniqKey="Delahunt B" first="B" last="Delahunt">B. Delahunt</name><affiliation wicri:level="1"><nlm:affiliation>Department of Pathology and Molecular Medicine, Wellington School of Medicine and Health Sciences, Wellington, New Zealand.</nlm:affiliation><country xml:lang="fr">Nouvelle-Zélande</country><wicri:regionArea>Department of Pathology and Molecular Medicine, Wellington School of Medicine and Health Sciences, Wellington</wicri:regionArea><wicri:noRegion>Wellington</wicri:noRegion></affiliation></author><author><name sortKey="Egevad, L" sort="Egevad, L" uniqKey="Egevad L" first="L" last="Egevad">L. 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Dagher</name><affiliation wicri:level="1"><nlm:affiliation>Aquesta Uro-pathology, University of Queensland, Brisbane, QLD, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Aquesta Uro-pathology, University of Queensland, Brisbane, QLD</wicri:regionArea><wicri:noRegion>QLD</wicri:noRegion></affiliation></author><author><name sortKey="Delahunt, B" sort="Delahunt, B" uniqKey="Delahunt B" first="B" last="Delahunt">B. Delahunt</name><affiliation wicri:level="1"><nlm:affiliation>Department of Pathology and Molecular Medicine, Wellington School of Medicine and Health Sciences, Wellington, New Zealand.</nlm:affiliation><country xml:lang="fr">Nouvelle-Zélande</country><wicri:regionArea>Department of Pathology and Molecular Medicine, Wellington School of Medicine and Health Sciences, Wellington</wicri:regionArea><wicri:noRegion>Wellington</wicri:noRegion></affiliation></author><author><name sortKey="Egevad, L" sort="Egevad, L" uniqKey="Egevad L" first="L" last="Egevad">L. Egevad</name><affiliation wicri:level="3"><nlm:affiliation>Department of Oncology Pathology, Karolineska Institute, Stockholm, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Oncology Pathology, Karolineska Institute, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Srigley, J" sort="Srigley, J" uniqKey="Srigley J" first="J" last="Srigley">J. Srigley</name><affiliation wicri:level="1"><nlm:affiliation>Trilium Health Partners and University Toronto, Mississauga, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Trilium Health Partners and University Toronto, Mississauga, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation></author><author><name sortKey="Samaratunga, H" sort="Samaratunga, H" uniqKey="Samaratunga H" first="H" last="Samaratunga">H. Samaratunga</name><affiliation wicri:level="1"><nlm:affiliation>Aquesta Uro-pathology, University of Queensland, Brisbane, QLD, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Aquesta Uro-pathology, University of Queensland, Brisbane, QLD</wicri:regionArea><wicri:noRegion>QLD</wicri:noRegion></affiliation></author></analytic><series><title level="j">World journal of urology</title><idno type="eISSN">1433-8726</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Performing an extended pelvic lymph node dissection (PLND) on all men with intermediate- and high-risk prostate cancer at the time of a radical prostatectomy (RP) remains controversial. The majority of patients PLND histology is benign, and the long-term cancer-free progression in men with positive lymph node metastasis is low. The objective is to investigate the probability of long-term biochemical freedom from recurrent disease (bNED) in men with lymph node metastasis identified at the time of radical prostatectomy (RP).</div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">29116393</PMID><DateCreated><Year>2017</Year><Month>11</Month><Day>08</Day></DateCreated><DateRevised><Year>2017</Year><Month>11</Month><Day>08</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1433-8726</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2017</Year><Month>Nov</Month><Day>07</Day></PubDate></JournalIssue><Title>World journal of urology</Title><ISOAbbreviation>World J Urol</ISOAbbreviation></Journal><ArticleTitle>Reconsidering the role of pelvic lymph node dissection with radical prostatectomy for prostate cancer in an era of improving radiological staging techniques.</ArticleTitle><ELocationID EIdType="doi" ValidYN="Y">10.1007/s00345-017-2119-0</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Performing an extended pelvic lymph node dissection (PLND) on all men with intermediate- and high-risk prostate cancer at the time of a radical prostatectomy (RP) remains controversial. The majority of patients PLND histology is benign, and the long-term cancer-free progression in men with positive lymph node metastasis is low. The objective is to investigate the probability of long-term biochemical freedom from recurrent disease (bNED) in men with lymph node metastasis identified at the time of radical prostatectomy (RP).</AbstractText><AbstractText Label="SUBJECTS AND METHODS" NlmCategory="METHODS">A retrospective review of the pathology of 1184 pelvic lymph node dissections performed at the time of a radical prostatectomy by multiple surgeons referred to a single uro-pathology laboratory between 2008 and 2014 identified 61 men with node-positive prostate cancer. Of the men with positive nodes, 24 had a standard PLND and 37 an extended PLND (ePLND). bNED was defined as a post-operative serum PSA < 0.2 ng/ml.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">The median follow-up is 4 years (2-8). The median lymph node count was 7 (range 2-16) for PLND and 22 (range 6-46) for the ePLND. A single lymph node metastasis was identified in 56% of the 61 men. Only 10% of men with a positive lymph node metastasis remained free of biochemical recurrence of disease, and only 5% had undetectable serum PSA. There was no difference in bNED outcome between a PLND and ePLND. The number of men needed to be treated with a PLND at the time of RP (NNT) to result in an undetectable post-operative PSA at a median follow-up of 4 years is 395.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">In men with lymph node metastasis, the probability of long-term bNED is low and the NNT for cure is high. With emerging improved radiological imaging techniques increasing the detection of lymph node metastasis outside the extended lymph node dissection templates, more scientific investigation is required to evaluate which men will benefit from a PLND and which men can avoid an unnecessary PLND procedure.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Yaxley</LastName><ForeName>J W</ForeName><Initials>JW</Initials><Identifier Source="ORCID">http://orcid.org/0000-0001-6566-9037</Identifier><AffiliationInfo><Affiliation>Wesley Urology Clinic, Brisbane, QLD, Australia. john@wesleyurologyclinic.com.au.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dagher</LastName><ForeName>J</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Aquesta Uro-pathology, University of Queensland, Brisbane, QLD, Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Rennes University Hospital, University of Rennes, Rennes, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Delahunt</LastName><ForeName>B</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Department of Pathology and Molecular Medicine, Wellington School of Medicine and Health Sciences, Wellington, New Zealand.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Egevad</LastName><ForeName>L</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Department of Oncology Pathology, Karolineska Institute, Stockholm, Sweden.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Srigley</LastName><ForeName>J</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Trilium Health Partners and University Toronto, Mississauga, ON, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Samaratunga</LastName><ForeName>H</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Aquesta Uro-pathology, University of Queensland, Brisbane, QLD, Australia.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2017</Year><Month>11</Month><Day>07</Day></ArticleDate></Article><MedlineJournalInfo><Country>Germany</Country><MedlineTA>World J Urol</MedlineTA><NlmUniqueID>8307716</NlmUniqueID><ISSNLinking>0724-4983</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Long-term outcome</Keyword><Keyword MajorTopicYN="N">Lymph node metastasis</Keyword><Keyword MajorTopicYN="N">PET-PSMA scan</Keyword><Keyword MajorTopicYN="N">PLND</Keyword><Keyword MajorTopicYN="N">Pelvic lymph node dissection</Keyword><Keyword MajorTopicYN="N">Prostate cancer</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2017</Year><Month>09</Month><Day>16</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2017</Year><Month>10</Month><Day>30</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2017</Year><Month>11</Month><Day>9</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2017</Year><Month>11</Month><Day>9</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>11</Month><Day>9</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>aheadofprint</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">29116393</ArticleId><ArticleId IdType="doi">10.1007/s00345-017-2119-0</ArticleId><ArticleId IdType="pii">10.1007/s00345-017-2119-0</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Australie</li><li>Canada</li><li>Nouvelle-Zélande</li><li>Suède</li></country><region><li>Svealand</li></region><settlement><li>Stockholm</li></settlement></list><tree><country name="Australie"><noRegion><name sortKey="Yaxley, J W" sort="Yaxley, J W" uniqKey="Yaxley J" first="J W" last="Yaxley">J W Yaxley</name></noRegion><name sortKey="Dagher, J" sort="Dagher, J" uniqKey="Dagher J" first="J" last="Dagher">J. Dagher</name><name sortKey="Samaratunga, H" sort="Samaratunga, H" uniqKey="Samaratunga H" first="H" last="Samaratunga">H. Samaratunga</name></country><country name="Nouvelle-Zélande"><noRegion><name sortKey="Delahunt, B" sort="Delahunt, B" uniqKey="Delahunt B" first="B" last="Delahunt">B. Delahunt</name></noRegion></country><country name="Suède"><region name="Svealand"><name sortKey="Egevad, L" sort="Egevad, L" uniqKey="Egevad L" first="L" last="Egevad">L. Egevad</name></region></country><country name="Canada"><noRegion><name sortKey="Srigley, J" sort="Srigley, J" uniqKey="Srigley J" first="J" last="Srigley">J. Srigley</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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