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Complications of pelvic lymph node dissection for prostate cancer.

Identifieur interne : 004F87 ( Main/Exploration ); précédent : 004F86; suivant : 004F88

Complications of pelvic lymph node dissection for prostate cancer.

Auteurs : K A Keegan [États-Unis] ; M S Cookson

Source :

RBID : pubmed:21394597

Descripteurs français

English descriptors

Abstract

Pelvic lymph node dissection (PLND) represents the standard for detection of occult pelvic nodal metastases from prostate cancer, and may be performed separately from or at the time of radical prostatectomy. In addition to its potential for diagnostic staging, a PLND may be therapeutic in some patients. However, considerable debate centers on the appropriate candidates for the procedure, the extent and proper boundaries of dissection, optimal surgical approach, and absolute oncologic benefit. Several series suggest that there likely is limited benefit of PLND in low-risk patients and that PLND can be safely omitted in a high percentage of men undergoing contemporary radical prostatectomy. Furthermore, the value of PLND in patients with intermediate- and high-risk disease must be balanced against the potential morbidity of the procedure. In the setting of this debate, concern over morbidity directly attributable to this procedure is of paramount importance. This review focuses on the complications associated with PLND, including lymphocele, thromboembolic events, ureteral injury, nerve injury, vascular injury, and lymphedema.

DOI: 10.1007/s11934-011-0179-z
PubMed: 21394597


Affiliations:


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Le document en format XML

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<term>Dissection (adverse effects)</term>
<term>Humans</term>
<term>Incidence</term>
<term>Lymph Node Excision (adverse effects)</term>
<term>Lymph Node Excision (methods)</term>
<term>Lymph Nodes (pathology)</term>
<term>Lymph Nodes (surgery)</term>
<term>Lymphedema (etiology)</term>
<term>Lymphedema (physiopathology)</term>
<term>Lymphocele (etiology)</term>
<term>Lymphocele (physiopathology)</term>
<term>Male</term>
<term>Neoplasm Invasiveness (pathology)</term>
<term>Neoplasm Staging</term>
<term>Pelvis (pathology)</term>
<term>Pelvis (surgery)</term>
<term>Postoperative Complications (epidemiology)</term>
<term>Postoperative Complications (physiopathology)</term>
<term>Prognosis</term>
<term>Prostatic Neoplasms (mortality)</term>
<term>Prostatic Neoplasms (pathology)</term>
<term>Prostatic Neoplasms (surgery)</term>
<term>Pulmonary Embolism (etiology)</term>
<term>Pulmonary Embolism (physiopathology)</term>
<term>Risk Assessment</term>
<term>Survival Analysis</term>
<term>Vascular System Injuries (etiology)</term>
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<term>Venous Thrombosis (etiology)</term>
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<term>Analyse de survie</term>
<term>Complications postopératoires (physiopathologie)</term>
<term>Complications postopératoires (épidémiologie)</term>
<term>Dissection (effets indésirables)</term>
<term>Embolie pulmonaire (physiopathologie)</term>
<term>Embolie pulmonaire (étiologie)</term>
<term>Humains</term>
<term>Incidence</term>
<term>Invasion tumorale (anatomopathologie)</term>
<term>Lymphadénectomie ()</term>
<term>Lymphadénectomie (effets indésirables)</term>
<term>Lymphocèle (physiopathologie)</term>
<term>Lymphocèle (étiologie)</term>
<term>Lymphoedème (physiopathologie)</term>
<term>Lymphoedème (étiologie)</term>
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<term>Pelvis (anatomopathologie)</term>
<term>Pronostic</term>
<term>Stade de la tumeur</term>
<term>Thrombose veineuse (physiopathologie)</term>
<term>Thrombose veineuse (étiologie)</term>
<term>Tumeurs de la prostate ()</term>
<term>Tumeurs de la prostate (anatomopathologie)</term>
<term>Tumeurs de la prostate (mortalité)</term>
<term>Évaluation des risques</term>
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<term>Dissection</term>
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<term>Tumeurs de la prostate</term>
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<term>Lymph Nodes</term>
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<term>Complications postopératoires</term>
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<term>Lésions du système vasculaire</term>
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<term>Incidence</term>
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<term>Neoplasm Staging</term>
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<term>Risk Assessment</term>
<term>Survival Analysis</term>
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<term>Humains</term>
<term>Incidence</term>
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<term>Mâle</term>
<term>Noeuds lymphatiques</term>
<term>Pelvis</term>
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<front>
<div type="abstract" xml:lang="en">Pelvic lymph node dissection (PLND) represents the standard for detection of occult pelvic nodal metastases from prostate cancer, and may be performed separately from or at the time of radical prostatectomy. In addition to its potential for diagnostic staging, a PLND may be therapeutic in some patients. However, considerable debate centers on the appropriate candidates for the procedure, the extent and proper boundaries of dissection, optimal surgical approach, and absolute oncologic benefit. Several series suggest that there likely is limited benefit of PLND in low-risk patients and that PLND can be safely omitted in a high percentage of men undergoing contemporary radical prostatectomy. Furthermore, the value of PLND in patients with intermediate- and high-risk disease must be balanced against the potential morbidity of the procedure. In the setting of this debate, concern over morbidity directly attributable to this procedure is of paramount importance. This review focuses on the complications associated with PLND, including lymphocele, thromboembolic events, ureteral injury, nerve injury, vascular injury, and lymphedema.</div>
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