دورية أكاديمية
Location-Based Oncological Outcomes of Sentinel Node Dissection in Radical Prostatectomy.
| العنوان: | Location-Based Oncological Outcomes of Sentinel Node Dissection in Radical Prostatectomy. |
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| المؤلفون: | Droghetti M; Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.; Department of Urology, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, The Netherlands., Ozman O; Department of Urology, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, The Netherlands., Berrens AC; Department of Urology, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, The Netherlands., Piazza P; Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy., Paccapelo A; Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy., van Vliet R; Department of Urology, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, The Netherlands., Schiavina R; Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy., Brunocilla E; Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy., Bekers E; Department of Pathology, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, The Netherlands., Donswijk M; Department of Nuclear Medicine, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, The Netherlands., van Leeuwen FWB; Department of Urology, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, The Netherlands.; Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands., van der Poel H; Department of Urology, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, The Netherlands.; Department of Urology, Amsterdam University Medical Centers, Amsterdam, The Netherlands. |
| المصدر: | The Journal of urology [J Urol] 2024 Sep; Vol. 212 (3), pp. 409-419. Date of Electronic Publication: 2024 May 24. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wolters Kluwer Country of Publication: United States NLM ID: 0376374 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1527-3792 (Electronic) Linking ISSN: 00225347 NLM ISO Abbreviation: J Urol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2019- : [Philadelphia, PA] : Wolters Kluwer Original Publication: Baltimore : Lippincott Williams & Wilkins |
| مواضيع طبية MeSH: | Prostatectomy*/methods , Prostatic Neoplasms*/surgery , Prostatic Neoplasms*/pathology , Prostatic Neoplasms*/mortality , Lymph Node Excision*/methods, Humans ; Male ; Middle Aged ; Retrospective Studies ; Aged ; Sentinel Lymph Node Biopsy/methods ; Sentinel Lymph Node/pathology ; Sentinel Lymph Node/surgery ; Sentinel Lymph Node/diagnostic imaging ; Neoplasm Staging ; Lymphatic Metastasis ; Treatment Outcome |
| مستخلص: | Purpose: Our study aimed to assess the oncological outcomes of sentinel node dissection during radical prostatectomy according to nodal location in comparison to extended pelvic lymph node dissection. Materials and Methods: Prospectively collected data of clinically node-negative patients who underwent prostatectomy and extended lymph node dissection with or without sentinel node from January 2013 to January 2023 were retrospectively analyzed. The primary end point was to assess oncological outcomes on the whole population. Kaplan-Meier curves were used to depict biochemical and clinical recurrence-free survival. Multivariable Cox regression models assessed the impact of nodal location on single-photon emission computed tomography on oncological outcomes. Adjustment for case mix included: pathological T stage, ISUP (International Society of Urological Pathology) grade group, initial PSA, nodal burden, age at surgery, and surgical margin status. Secondarily, a propensity score match was performed according to age at surgery, PSA, biopsy ISUP, clinical T stage, and Briganti risk of nodal invasion. Survival and regression analyses were also performed in the matched population. Results: Of the patients, 55.8% had at least 1 sentinel node outside of lymph node dissection template at single-photon emission computed tomography/CT. Log-rank test showed comparable 36-month biochemical ( P = .3) and clinical recurrence-free survival ( P = .6) among patients with sentinel node inside template, outside template, or extended pelvic lymph node dissection alone. At Cox regression, sentinel node location outside template was associated with lower hazard of metastases (HR 0.62; P = .04) in the overall cohort, while in the matched cohort benefits were observed only for biochemical recurrence (HR 0.57; P = .001). Conclusions: Wider nodal resection boundaries outside the "classic" template, driven by sentinel node procedure, have a positive impact on oncological outcomes in selected patient. |
| التعليقات: | Comment in: J Urol. 2024 Sep;212(3):418-419. doi: 10.1097/JU.0000000000004075. (PMID: 38838265) |
| فهرسة مساهمة: | Keywords: lymph node dissection; prostate cancer; radical prostatectomy; radioguided; sentinel node |
| تواريخ الأحداث: | Date Created: 20240524 Date Completed: 20240808 Latest Revision: 20240808 |
| رمز التحديث: | 20240808 |
| DOI: | 10.1097/JU.0000000000004051 |
| PMID: | 38787799 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1527-3792 |
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| DOI: | 10.1097/JU.0000000000004051 |