268 Patients with lymph-node metastasis after radical prostatectomy and pelvic lymph-node dissection are not all subject to the same risk of cancer death: Identifying different risk-category according to the number of positive nodes and Gleason score

Abstract Introduction: There are controversies over the treatment options for pelvic lymph node metastasis in low rectal cancer. The role of neoadjuvant radiotherapy in radical treatment of pelvic lymph node metastasis is still unidentified. Total mesorectal excision (TME) with Laparoscopic pelvic lymph node dissection (LPLND) provides lower pelvic recurrence in 5 years than TME only. Material and Methods: Prospective, uncontrolled clinical trial for patients with low rectal cancer (below peritoneal fold), who had suspected lateral pelvic lymph node metastasis on MRI scan and the patients did not have contraindication for laparoscopic surgery. Result: From January 2017 to February 2018 we performed 12 cases of LPLND. There was no con-version to open surgery. The average time for lymphadenectomy is 75 minutes with an average amount of blood loss of 97ml. Only 1 case had postoperative urinary retention (8%). The rate of pos-itive pelvic node was 5.8%, with an average of resected nodes of 4.9 nodes. Lymph nodes size on MRI scan in the positive pelvic node group was 20.6mm, compared to 7mm in the negative group. Conclusion: Laparoscopic lateral pelvic lymph node dissection is a feasible and safe technique and should be done by experienced colorectal surgeons. Aging, female sex and pelvic lymph node size on MRI are related to pelvic lymph node metastasis.

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Is There an Oncological Benefit of Performing Bilateral Pelvic Lymph Node Dissection in Patients with Penile Cancer and Inguinal Lymph Node Metastasis?

Journal of Clinical Medicine ◽

10.3390/jcm10040754 ◽

2021 ◽

Vol 10 (4) ◽

pp. 754

Author(s):

Rodrigo Suarez-Ibarrola ◽

Mario Basulto-Martinez ◽

August Sigle ◽

Mohammad Abufaraj ◽

Christian Gratzke ◽

...

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Lymph Node Dissection ◽

Penile Cancer ◽

Inguinal Lymph Node ◽

Pelvic Lymph Node Dissection ◽

Pelvic Lymph Node ◽

Node Dissection ◽

Inguinal Lymph Node Metastasis ◽

Node Metastasis

We aim to review the literature for studies investigating the oncological outcomes of patients with penile cancer (PC) undergoing bilateral pelvic lymph node dissection (PLND) in the presence of inguinal lymph node metastasis (LNM) who are at risk of harboring pelvic metastasis. A search of English language literature was performed using the PubMed-MEDLINE database up to 3 December 2020 to identify articles addressing bilateral PLND in PC patients. Eight articles investigating bilateral PLND met our inclusion criteria. Patients with pelvic LNM have a dismal prognosis and, therefore, PLND has an important role in both the staging and treatment of PC patients. Ipsilateral PLND is recommended in the presence of ≥2 positive inguinal nodes and/or extranodal extension (ENE). Significant survival improvements were observed with a higher pelvic lymph node yield, in patients with pN2 disease, and in men treated with bilateral PLND as opposed to ipsilateral PLND. Nevertheless, the role of bilateral PLND for unilateral inguinal LNM remains unclear. Although the EAU guidelines state that pelvic nodal disease does not occur without ipsilateral inguinal LNM, metastatic spread from one inguinal side to the contralateral pelvic side has been reported in a number of studies. Further studies are needed to clarify the disseminative pattern of LNM, in order to establish PLND templates according to patients’ risk profiles and to investigate the benefit of performing bilateral PLND for unilateral inguinal disease.

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