PD14-08 AMOUNT OF DISSECTED LYMPH NODES DURING RADICAL PROSTATECTOMY DOES NOT DEPEND ON SURGICAL APPROACH IN A SINGLE HIGH-VOLUME CENTER

Abstract

You have accessJournal of UrologyProstate Cancer: Localized II1 Apr 2014PD14-08 AMOUNT OF DISSECTED LYMPH NODES DURING RADICAL PROSTATECTOMY DOES NOT DEPEND ON SURGICAL APPROACH IN A SINGLE HIGH-VOLUME CENTER Burkhard Beyer, Pierre Tennstedt, Katharina Boehm, Jonas Schiffmann, Alexander Haese, and Markus Graefen Burkhard BeyerBurkhard Beyer More articles by this author , Pierre TennstedtPierre Tennstedt More articles by this author , Katharina BoehmKatharina Boehm More articles by this author , Jonas SchiffmannJonas Schiffmann More articles by this author , Alexander HaeseAlexander Haese More articles by this author , and Markus GraefenMarkus Graefen More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1285AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Pelvic lymph node dissection (pLND) during radical prostatectomy (RP) for prostate cancer (PCa) is a staging tool with clear impact on potential adjuvant treatment. Since different surgical approaches such as robotic assisted radical prostatectomy (RARP) and open radical prostatectomy (ORP) are routinely performed it is important to investigate whether differences in lymph node yield adherent to the respective surgical technique exist. Since lymph node yield and indication for pLND heavily depend on treatment pattern in the respective institution and surgical experience it is important to investigate the effect of the respective approach in a setting in which both techniques are routinely offered as a high-volume procedure. METHODS Retrospective assessment of 2152 men treated with ORP (79.4%) or RARP (20.6%) including pLND for clinically localized PCa at a tertiary care center in one year (March 2012 – March 2013). A 1 to 1 propensity score matching was performed for 804 patients accounting for different patient characteristic between the groups. Propensity score was matched for age, BMI, Gleason score, clinical Tumor stage and preoperative PSA. A multivariate regression analysis was performed. Stratification into low-, intermediate- and high-risk group was performed according to D’Amico and comparison of number of dissected lymph nodes. RESULTS No differences in baseline characteristics (age, BMI, Gleason score, preoperative PSA, clinical T-stage) between both matched groups were detected (p>0.05). Number of resected lymph nodes was comparable (median 8 (IQR 4-14) RARP vs. median 8 (IQR 4-15) ORP). The frequency of patients with more than 10 resected lymph nodes varied between D’Amico risk groups (low: 19.5%; intermediate: 41.2%; high: 59.3%), but not between surgical techniques (RARP vs. ORP for low: 19.8%/19.3%, intermediate: 38.7%/43.8%, and high: 59.3%/59.3%). Multivariate logistic regression analysis including surgical technique, age at surgery, BMI, clinical stage, Gleason score and preoperative PSA showed that only biopsy Gleason score had a significant influence on LN yield (p<0.0001). In a comparison of 3 high volume surgeons who offer both techniques no difference in the number of resected lymph nodes was seen. CONCLUSIONS Our data show no differences between lymph node yield and the surgical technique in a high-volume center. Various factors influence number of taken lymph nodes but not surgical approach itself. For experienced surgeons there are no drawbacks regarding pLND when RARP is used. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e413-e414 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Burkhard Beyer More articles by this author Pierre Tennstedt More articles by this author Katharina Boehm More articles by this author Jonas Schiffmann More articles by this author Alexander Haese More articles by this author Markus Graefen More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...