MP52-03 CORRELATION OF THE TYPE OF PELVIC NODE DISSECTION DURING RADICAL PROSTATECTOMY TO THE PATTERN OF NODAL RECURRENCE AT SALVAGE LYMPHADENECTOMY FOR PROSTATE CANCER (2018)

You have accessJournal of UrologyProstate Cancer: Advanced (including Drug Therapy) III1 Apr 2018MP52-03 CORRELATION OF THE TYPE OF PELVIC NODE DISSECTION DURING RADICAL PROSTATECTOMY TO THE PATTERN OF NODAL RECURRENCE AT SALVAGE LYMPHADENECTOMY FOR PROSTATE CANCER Arjun Sivaraman, Nicole Benfante, Karim Touijer, Jonathan Coleman, Peter Scardino, Vincent Laudone, and James Eastham Arjun SivaramanArjun Sivaraman More articles by this author , Nicole BenfanteNicole Benfante More articles by this author , Karim TouijerKarim Touijer More articles by this author , Jonathan ColemanJonathan Coleman More articles by this author , Peter ScardinoPeter Scardino More articles by this author , Vincent LaudoneVincent Laudone More articles by this author , and James EasthamJames Eastham More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1654AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In prostate cancer (PCa) patients, lymph node recurrence can be a cause for the biochemical recurrence (BCR) following radical prostatectomy (RP). The aim is to verify the type of pelvic lymph node dissection (PLND) performed at RP and correlate it with the anatomical pattern of nodal recurrence in patients undergoing salvage lymph node dissection (sLND) METHODS Prospectively maintained institutional database of 48 patients (1998 – 2017) who underwent sLND for presumed nodal recurrence were reviewed. Characteristics at primary RP/PLND (type, template, number of nodes removed, node positive rate, final pathology, BCR, salvage treatments) were identified (table 1) and correlated with recurrence in terms of number and pelvic nodal anatomic levels reported in radiological imaging and the final template based sLND pathology specimen RESULTS At RP, only 8 (17%) patients received an “extended” PLND (external iliac, hypogastric, and obturator), while 8 (17%) never had PLND and 32 (67%) had a “limited” PLND (between external iliac vein and obturator nerve). Median nodes removed at limited and extended PLND were 2 and 24 respectively. At sLND, mean age was 61.3 years and median PSA was 1.07 ng/ml.(table 2) Median nodes removed at sLND were 17 with a median of 2 positive nodes. Among the patients who underwent prior extend PLND at RP, the recurrent nodes were located within the anatomical template of level 1 and/or 2 in only 1 (12.5%) patient and 3 (37.5%) patients had recurrence outside the expected lymphatic drainage pathway. Recurrent nodes were detected in the level 1 and/or 2 in 16 (50%) and 5 (62.5%) patients respectively following prior limited or no PLND at RP. Pre-sLND imaging identified the anatomic location of the recurrent nodes in 83% but underestimated the number of nodes in 42% patients CONCLUSIONS In PCa patients undergoing sLND, most had an inadequate PLND at the original RP. Pattern of nodal recurrence may be influenced by the prior dissection and pre sLND imaging appears to underestimate the nodal recurrence © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e694-e695 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Arjun Sivaraman More articles by this author Nicole Benfante More articles by this author Karim Touijer More articles by this author Jonathan Coleman More articles by this author Peter Scardino More articles by this author Vincent Laudone More articles by this author James Eastham More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...