MP15-07 ANALYSIS OF PERIOPERATIVE COMPLICATIONS IN PATIENTS WITH PROSTATE CANCER BASED ON EXTENSION OF PELVIC LYMPH NODE DISSECTION

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy I (MP15)1 Sep 2021MP15-07 ANALYSIS OF PERIOPERATIVE COMPLICATIONS IN PATIENTS WITH PROSTATE CANCER BASED ON EXTENSION OF PELVIC LYMPH NODE DISSECTION Marissa Maas, Nima Nassiri, Paolo Dell’Oglio, George Thalmann, Axel Heidenreich, James Eastham, Christopher Evans, Jeffrey Karnes, Andre Abreu, Alberto Briganti, Walter Artibani, Inderbir Gill, Francesco Montorsi, and Giovanni Cacciamani Marissa MaasMarissa Maas More articles by this author , Nima NassiriNima Nassiri More articles by this author , Paolo Dell’OglioPaolo Dell’Oglio More articles by this author , George ThalmannGeorge Thalmann More articles by this author , Axel HeidenreichAxel Heidenreich More articles by this author , James EasthamJames Eastham More articles by this author , Christopher EvansChristopher Evans More articles by this author , Jeffrey KarnesJeffrey Karnes More articles by this author , Andre AbreuAndre Abreu More articles by this author , Alberto BrigantiAlberto Briganti More articles by this author , Walter ArtibaniWalter Artibani More articles by this author , Inderbir GillInderbir Gill More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Giovanni CacciamaniGiovanni Cacciamani More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001996.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: While there is consensus on the importance of pelvic lymph node dissection (PLND) in the staging and management of clinically localized prostate cancer, there is controversy regarding the optimal extent of PLND. The European Association of Urology (EAU) currently recommends an extended PLND (ePLND) for high-risk patients. In this study, we evaluated the difference in non-oncologic complication rates following standard PLND (sPLND) vs. ePLND. METHODS: A systematic review and metanalysis in accordance with the Preferred Reporting Items for Systematic Review and Metanalysis guidelines was conducted. Our team queried Medline, Web of Science, Scopus, and Embase for all papers reporting intra- or postoperative outcomes of radical prostatectomy and PLND. We defined sPLND and ePLND according to EAU guidelines. Data was collected for patient demographics, quality of complication reporting, intraoperative, and postoperative complications. RESULTS: 3,645 papers were collected and 176 met inclusion criteria. 84 described intraoperative complications with a total of 28,428 patients. 534 (1.8%) patients suffered at least one intraoperative complication and rectal injury was most common. The rate of intraoperative complications strongly related to PLND was 11.6%, including obturator nerve and iliac vessel injury. 151 papers with a total of 73,629 patients analyzed postoperative complications. 19 papers reported the complication rates following sPLND vs. ePLND. 10,401 (14.1%) patients reported at least one postoperative complication. Lymphatic system morbidities were most common. The most frequently reported complication strongly related to PLND was lymphocele (90.6%). According to metanalysis, there was a statistically significant decreased risk of intraoperative (RR:0.55; p=0.01) and PLND-related postoperative complications (RR:0.55; p=0.01) with standard/limited PLND compared to extended/super-extended. Extent of PLND is an independent predictor of lymphocele (RR:1.77, p>0.0001). CONCLUSIONS: While there may be an oncologic benefit conferred by ePLND, it is associated with increased risk of intraoperative and postoperative complications, especially lymphocele formation. It is imperative that shared decision is undertaken when deciding extent of PLND. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e266-e266 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Marissa Maas More articles by this author Nima Nassiri More articles by this author Paolo Dell’Oglio More articles by this author George Thalmann More articles by this author Axel Heidenreich More articles by this author James Eastham More articles by this author Christopher Evans More articles by this author Jeffrey Karnes More articles by this author Andre Abreu More articles by this author Alberto Briganti More articles by this author Walter Artibani More articles by this author Inderbir Gill More articles by this author Francesco Montorsi More articles by this author Giovanni Cacciamani More articles by this author Expand All Advertisement Loading ...