Laparoscopic sentinel lymph node (SLN) versus extensive pelvic dissection for clinically localized prostate carcinoma View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2011-11-16

AUTHORS

Caroline Rousseau, Thierry Rousseau, Boumédiène Bridji, Amandine Pallardy, Jacques Lacoste, Loïc Campion, Aude Testard, Geneviève Aillet, Ayat Mouaden, Chantal Curtet, Françoise Kraeber-Bodéré

ABSTRACT

PurposeLymph node metastasis is an important prognostic factor in prostate cancer (PC). The aim of this prospective study was to evaluate the accuracy of sentinel lymph node (SLN) biopsy by laparoscopy in staging locoregional patients with clinically localized PC.MethodsA transrectal ultrasound-guided injection of 0.3 ml/100 MBq 99mTc-sulphur rhenium colloid in each prostatic lobe was performed the day before surgery. Detection was performed intraoperatively with a laparoscopic probe (Gamma Sup CLERAD®) followed by extensive resection. SLN counts were performed in vivo and confirmed ex vivo. Histological analysis was performed by haematoxylin-phloxine-saffron staining, followed by immunohistochemistry (IHC) if the SLN was free of metastasis.ResultsThe study included 93 patients with PC at intermediate or high risk of lymph node metastases. The intraoperative detection rate was 93.5% (87/93). Nineteen patients had lymph node metastases, nine only in SLN. The false-negative rate was 10.5% (2/19). The internal iliac region was the primary metastatic site (43.3%). Metastatic sentinel nodes in the common iliac region beyond the ureteral junction were present in 13.3%. Limited or standard lymph node resection would have ignored 73.2 and 56.6% of lymph node metastases, respectively.ConclusionLaparoscopy is suitable for broad identification of SLN metastasis, and targeted resection of these lymph nodes significantly limits the risk of extended surgical resection whilst maintaining the accuracy of the information. More... »

PAGES

291-299

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00259-011-1975-x

DOI

http://dx.doi.org/10.1007/s00259-011-1975-x

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1001696818

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/22086144


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27 schema:description PurposeLymph node metastasis is an important prognostic factor in prostate cancer (PC). The aim of this prospective study was to evaluate the accuracy of sentinel lymph node (SLN) biopsy by laparoscopy in staging locoregional patients with clinically localized PC.MethodsA transrectal ultrasound-guided injection of 0.3 ml/100 MBq 99mTc-sulphur rhenium colloid in each prostatic lobe was performed the day before surgery. Detection was performed intraoperatively with a laparoscopic probe (Gamma Sup CLERAD®) followed by extensive resection. SLN counts were performed in vivo and confirmed ex vivo. Histological analysis was performed by haematoxylin-phloxine-saffron staining, followed by immunohistochemistry (IHC) if the SLN was free of metastasis.ResultsThe study included 93 patients with PC at intermediate or high risk of lymph node metastases. The intraoperative detection rate was 93.5% (87/93). Nineteen patients had lymph node metastases, nine only in SLN. The false-negative rate was 10.5% (2/19). The internal iliac region was the primary metastatic site (43.3%). Metastatic sentinel nodes in the common iliac region beyond the ureteral junction were present in 13.3%. Limited or standard lymph node resection would have ignored 73.2 and 56.6% of lymph node metastases, respectively.ConclusionLaparoscopy is suitable for broad identification of SLN metastasis, and targeted resection of these lymph nodes significantly limits the risk of extended surgical resection whilst maintaining the accuracy of the information.
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34 ResultsThe study
35 SLN count
36 SLN metastasis
37 accuracy
38 aim
39 analysis
40 biopsy
41 broad identification
42 cancer
43 carcinoma
44 colloids
45 common iliac region
46 count
47 days
48 detection
49 detection rate
50 dissection
51 extended surgical resection
52 extensive pelvic dissection
53 extensive resection
54 factors
55 false negative rate
56 high risk
57 histological analysis
58 identification
59 iliac region
60 immunohistochemistry
61 important prognostic factor
62 information
63 injection
64 internal iliac region
65 intraoperative detection rate
66 junction
67 laparoscopic probe
68 laparoscopy
69 lobe
70 lymph
71 lymph node biopsy
72 lymph node metastasis
73 lymph node resection
74 lymph nodes
75 metastasis
76 metastatic sentinel nodes
77 metastatic sites
78 ml/100
79 node biopsy
80 node metastasis
81 node resection
82 nodes
83 patients
84 pelvic dissection
85 primary metastatic site
86 probe
87 prognostic factors
88 prospective study
89 prostate cancer
90 prostate carcinoma
91 prostatic lobes
92 rate
93 region
94 resection
95 rhenium colloid
96 risk
97 saffron staining
98 sentinel lymph node biopsy
99 sentinel lymph nodes
100 sentinel nodes
101 sites
102 staining
103 study
104 surgery
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107 vivo
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