Effect of extended vs standard pelvic lymphadenectomy
February 20th, 2010 Posted in prostate cancerA recent study at The Royal Surrey County Hospital, Guildford, UK, investigated the effect of extended vs standard pelvic lymphadenectomy (sPLND) for patients with intermediate- and high-risk prostate cancer undergoing laparoscopic radical prostatectomy (LRP).
Study team has published data from their series of 1,269 patients treated with non-robot-assisted laparoscopic radical prostatectomy (LRP) over a period of just over 9 years (starting in 2000).
Based on their findings and the results of other studies which show a reduction of prostate cancer-specific mortality of 23% if lymph nodes are positive and 15% if they are negative after ePLND, and the correlation between surgical experience, lymph node yield and positivity, researchers offer three recommendations:
(a) all patients should undergo ePLND if they are being treated with curative intent for intermediate- and high-risk prostate cancer;
(b) ePLND should replace sPLND for all such patients; and
(c) surgeons performing < 35 cases of RP a year should stop performing RP.