1642 PELVIC LYMPH NODE DISSECTION IS PERFORMED LESS FREQUENTLY IN PATIENTS TREATED WITH MINIMALLY INVASIVE RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized1 Apr 20111642 PELVIC LYMPH NODE DISSECTION IS PERFORMED LESS FREQUENTLY IN PATIENTS TREATED WITH MINIMALLY INVASIVE RADICAL PROSTATECTOMY Firas Abdollah, Jan Schmitges, Maxine Sun, Orchidee Djahangirian, Claudio Jeldres, Daniel Liberman, Al'a Abdo, Zhe Tian, Kevin Zorn, Markus Graefen, Paul Perrotte, Francesco Montorsi, and Pierre I. Karakiewicz Firas AbdollahFiras Abdollah Milan, Italy More articles by this author , Jan SchmitgesJan Schmitges Hamburg, Germany More articles by this author , Maxine SunMaxine Sun Montreal, Canada More articles by this author , Orchidee DjahangirianOrchidee Djahangirian Montreal, Canada More articles by this author , Claudio JeldresClaudio Jeldres Montreal, Canada More articles by this author , Daniel LibermanDaniel Liberman Montreal, Canada More articles by this author , Al'a AbdoAl'a Abdo Montreal, Canada More articles by this author , Zhe TianZhe Tian Montreal, Canada More articles by this author , Kevin ZornKevin Zorn Montreal, Canada More articles by this author , Markus GraefenMarkus Graefen Hamburg, Germany More articles by this author , Paul PerrottePaul Perrotte Montreal, Canada More articles by this author , Francesco MontorsiFrancesco Montorsi Milan, Italy More articles by this author , and Pierre I. KarakiewiczPierre I. Karakiewicz Montreal, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1751AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Pelvic lymph node dissection (PLND) represents the most accurate lymph node staging method at radical prostatectomy (RP), and may have a favorable effect on cancer control outcomes. However, PLND may be performed less frequently in patients treated with minimally invasive radical prostatectomy (MIRP). We tested this hypothesis in a large population-based cohort. METHODS We relied on 64900 RP records for patients treated between 2003 and 2007, within the Nationwide Inpatient Sample. PLND rates were stratified according to RP technique: open RP (ORP) vs. MIRP. Multivariable logistic regression analyses (MVA) tested the independent predictor status of RP technique as determinants of PLND. Covariates consisted of age, race, comorbidity, year of surgery, and annual hospital volume. RESULTS Average patient age was 61.0 years (median 61, range 35–95). PLND was performed in 56% of patients. MIRP was performed in 6.3% of patients, while ORP accounted for the remaining 93.7%. The rate of PLND was statistically significantly lower in patients treated with MIRP vs. ORP (30.3 vs. 57.8%, p<0.001). In MVA, patients treated with MIRP had a 64.2% lower probability of PLND in comparison to their counterparts treated with ORP (p<0.001). CONCLUSIONS Patients operated with MIRP have a lower rate of PLND in comparison to their ORP counterparts. This may decrease the accuracy of lymph node staging, and may lead to less favorable cancer control outcomes in these patients. Such an observation represents an important quality of care concern. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e659 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Firas Abdollah Milan, Italy More articles by this author Jan Schmitges Hamburg, Germany More articles by this author Maxine Sun Montreal, Canada More articles by this author Orchidee Djahangirian Montreal, Canada More articles by this author Claudio Jeldres Montreal, Canada More articles by this author Daniel Liberman Montreal, Canada More articles by this author Al'a Abdo Montreal, Canada More articles by this author Zhe Tian Montreal, Canada More articles by this author Kevin Zorn Montreal, Canada More articles by this author Markus Graefen Hamburg, Germany More articles by this author Paul Perrotte Montreal, Canada More articles by this author Francesco Montorsi Milan, Italy More articles by this author Pierre I. Karakiewicz Montreal, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...