Lymphadenectomy in Prostate Cancer: Technique and Outcomes

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bookPart
Data de publicação
2022
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Editora
SPRINGER INTERNATIONAL PUBLISHING
Autores
SALAS, R. S.
YOSHIOKA, K.
Citação
Lestingi, J. F. P.; Salas, R. S.; Yoshioka, K.; Coelho, R. F.. Lymphadenectomy in Prostate Cancer: Technique and Outcomes. In: . Robotic Urologic Surgery: Third Edition: SPRINGER INTERNATIONAL PUBLISHING, 2022. p.305-349.
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Resumo
Despite recent advances in imaging, pelvic lymph node dissection (PLND) remains the gold standard modality for nodal staging in prostate cancer (PCa) patients. There remains significant debate about PLND: the odds of finding positive pelvic lymph nodes are proportional to the extent of the PLND; however, the therapeutic benefits of more extensive PLND remain an area of controversy, besides the increasing number of surgical risks. This chapter will review indications, techniques, and results of extended pelvic lymphadenectomy (ePLND) in the surgical treatment of PCa patients. Two recent randomized controlled trials comparing extended to limited PLND have not demonstrated differences in early biochemical recurrence. Limited lymphadenectomy significantly underestimates the actual incidence of lymph node metastasis and should no longer be performed for staging. EPLND is currently the gold standard in lymph node staging. It should be reserved for patients at higher risk of lymph node invasion. The oncological role of ePLND is not defined. It can help patients directly (up to two positive lymph nodes), indirectly (select for adjuvant treatments), or may benefit patients with ISUP Gleason Grade in biopsy 3-5. EPLND is also associated with significantly worse intra- and postoperative non-oncological outcomes, such as bleeding, lymphocele, and increased surgical time. The oncological role of salvage lymphadenectomy also is not clear. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
Palavras-chave
Lymphatic metastasis, Pelvic lymph node dissection, Prognosis, Prostate cancer, Robotic-assisted lymphadenectomy
Referências
  1. Siegel R.L., Miller K.D., Fuchs H.E., Jemal A., Cancer statistics, 2021, CA Cancer J Clin, 71, 1, pp. 7-33, (2021)
  2. McLaughlin A.P., Saltzstein S.L., McCullough D.L., Gittes R.F., Prostatic carcinoma: Incidence and location of unsuspected lymphatic metastases, J Urol, 115, 1, pp. 89-94, (1976)
  3. Wolf J.S., Cher M., Dall'Era M., Presti J.C., Hricak H., Carroll P.R., The use and accuracy of cross-sectional imaging and fine needle aspiration cytology for detection of pelvic lymph node metastases before radical prostatectomy, J Urol, 153, 3, pp. 993-999, (1995)
  4. Katz S., Rosen M., MR imaging and MR spectroscopy in prostate cancer management, Radiol Clin N Am, 44, 5, pp. 723-734, (2006)
  5. Perera M., Papa N., Roberts M., Williams M., Udovicich C., Vela I., Et al., Gallium-68 prostate-specific membrane antigen positron emission tomography in advanced prostate cancer-updated diagnostic utility, sensitivity, specificity, and distribution of prostate-specific membrane antigen-avid lesions: A systematic review and meta-analysis, Eur Urol, 77, 4, pp. 403-417, (2020)
  6. Hyndman M.E., Mullins J.K., Pavlovich C.P., Pelvic node dissection in prostate cancer: Extended, limited, or not at all?, Curr Opin Urol, 20, 3, pp. 211-217, (2010)
  7. Heidenreich A., Still unanswered: The role of extended pelvic lymphadenectomy in improving oncological outcomes in prostate cancer, Eur Urol, 79, 5, pp. 605-606, (2021)
  8. Briganti A., Blute M.L., Eastham J.H., Graefen M., Heidenreich A., Karnes J.R., Et al., Pelvic lymph node dissection in prostate cancer, Eur Urol, 55, 6, pp. 1251-1265, (2009)
  9. Lestingi J.F.P., Guglielmetti G.B., Trinh Q.D., Coelho R.F., Pontes J., Bastos D.A., Et al., Extended versus limited pelvic lymph node dissection during radical prostatectomy for intermediate- and high-risk prostate cancer: Early oncological outcomes from a randomized phase 3 trial, Eur Urol, 79, 5, pp. 595-604, (2021)
  10. Touijer K.A., Sjoberg D.D., Benfante N., Laudone V.P., Ehdaie B., Eastham J.A., Et al., Limited versus extended pelvic lymph node dissection for prostate cancer: A randomized clinical trial, Eur Urol Oncol, 4, 4, pp. 532-539, (2021)
  11. Fossati N., Willemse P.M., Van den Broeck T., Van den Bergh R.C.N., Yuan C.Y., Briers E., Et al., The benefits and harms of different extents of lymph node dissection during radical prostatectomy for prostate cancer: A systematic review, Eur Urol, 72, 1, pp. 84-109, (2017)
  12. Heidenreich A., Varga Z., Von Knobloch R., Extended pelvic lymphadenectomy in patients undergoing radical prostatectomy: High incidence of lymph node metastasis, J Urol, 167, 4, pp. 1681-1686, (2002)
  13. Briganti A., Chun F.K., Salonia A., Suardi N., Gallina A., da Pozzo L.F., Et al., Complications and other surgical outcomes associated with extended pelvic lymphadenectomy in men with localized prostate cancer, Eur Urol, 50, 5, pp. 1006-1013, (2006)
  14. Sanda M.G., Cadeddu J.A., Kirkby E., Chen R.C., Crispino T., Fontanarosa J., Et al., Clinically localized prostate cancer: AUA/ ASTRO/SUO Guideline. Part I: Risk stratification, shared decision making, and care options, J Urol, 199, 3, pp. 683-690, (2018)
  15. Mottet N., Van den Bergh R.C.N., Briers E., Van den Broeck T., Cumberbatch M.G., de Santis M., Et al., EAU-EANM-ESTRO-ESUR-SIOG guidelines on prostate Cancer-2020 update. Part 1: Screening, diagnosis, and local treatment with curative intent, Eur Urol, 79, 2, pp. 243-262, (2021)
  16. Mohler J.L., Antonarakis E.S., Armstrong A.J., D'Amico A.V., Davis B.J., Dorff T., Et al., Prostate cancer, version 2.2019, NCCN clinical practice guidelines in oncology, J Natl Compr Cancer Netw, 17, 5, pp. 479-505, (2019)
  17. Luiting H.B., Van Leeuwen P.J., Busstra M.B., Brabander T., Van der Poel H.G., Donswijk M.L., Et al., Use of gallium-68 prostate-specific membrane antigen positron-emission tomography for detecting lymph node metastases in primary and recurrent prostate cancer and location of recurrence after radical prostatectomy: An overview of the current literature, BJU Int, 125, 2, pp. 206-214, (2020)
  18. Hope T.A., Armstrong W.R., Murthy V., Lawhn Heath C., Behr S., Barbato F., Et al., Accuracy of 68Ga-PSMA-11 for pelvic nodal metastasis detection prior to radical prostatectomy and pelvic lymph node dissection: A multicenter prospective phase III imaging study, J Clin Oncol, 38, (2020)
  19. Porcaro A.B., Cacciamani G.E., Sebben M., Tafuri A., Processali T., Rizzetto R., Et al., Lymph nodes invasion of Marcille’s fossa associates with high metastatic load in prostate cancer patients undergoing extended pelvic lymph node dissection: The role of “Marcillectomy”, Urol Int, 103, 1, pp. 25-32, (2019)
  20. Sagalovich D., Calaway A., Srivastava A., Sooriakumaran P., Tewari A.K., Assessment of required nodal yield in a high risk cohort undergoing extended pelvic lymphadenectomy in robotic-assisted radical prostatectomy and its impact on functional outcomes, BJU Int, 111, 1, pp. 85-94, (2013)
  21. Mattei A., Fuechsel F.G., Bhatta Dhar N., Warncke S.H., Thalmann G.N., Krause T., Et al., The template of the primary lymphatic landing sites of the prostate should be revisited: Results of a multimodality mapping study, Eur Urol, 53, 1, pp. 118-125, (2008)
  22. Bader P., Burkhard F.C., Markwalder R., Studer U.E., Is a limited lymph node dissection an adequate staging procedure for prostate cancer?, J Urol, 168, 2, pp. 514-518, (2002)
  23. Heidenreich A., Ohlmann C.H., Polyakov S., Anatomical extent of pelvic lymphadenectomy in patients undergoing radical prostatectomy, Eur Urol, 52, 1, pp. 29-37, (2007)
  24. Touijer K., Rabbani F., Otero J.R., Secin F.P., Eastham J.A., Scardino P.T., Et al., Standard versus limited pelvic lymph node dissection for prostate cancer in patients with a predicted probability of nodal metastasis greater than 1%, J Urol, 178, 1, pp. 120-124, (2007)
  25. Stone N.N., Stock R.G., Unger P., Laparoscopic pelvic lymph node dissection for prostate cancer: Comparison of the extended and modified techniques, J Urol, 158, 5, pp. 1891-1894, (1997)
  26. Briganti A., Chun F.K., Salonia A., Gallina A., Zanni G., Scattoni V., Et al., Critical assessment of ideal nodal yield at pelvic lymphadenectomy to accurately diagnose prostate cancer nodal metastasis in patients undergoing radical retropubic prostatectomy, Urology, 69, 1, pp. 147-151, (2007)
  27. Briganti A., Suardi N., Capogrosso P., Passoni N., Freschi M., Di Trapani E., Et al., Lymphatic spread of nodal metastases in high-risk prostate cancer: The ascending pathway from the pelvis to the retroperitoneum, Prostate, 72, 2, pp. 186-192, (2012)
  28. Joniau S., Van den Bergh L., Lerut E., Deroose C.M., Haustermans K., Oyen R., Et al., Mapping of pelvic lymph node metastases in prostate cancer, Eur Urol, 63, 3, pp. 450-458, (2013)
  29. Prasad S.M., Shalhav A.L., Comparative effectiveness of minimally invasive versus open lymphadenectomy in urological cancers, Curr Opin Urol, 23, 1, pp. 57-64, (2013)
  30. Barbosa F.G., Queiroz M.A., Nunes R.F., Viana P.C.C., Marin J.F.G., Cerri G.G., Et al., Revisiting prostate cancer recurrence with PSMA PET: Atlas of typical and atypical patterns of spread, Radiographics, 39, 1, pp. 186-212, (2019)
  31. Van der Poel H.G., Tillier C., de Blok W., Van Muilekom E., Extended nodal dissection reduces sexual function recovery after robot-assisted laparoscopic prostatectomy, J Endourol, 26, 9, pp. 1192-1198, (2012)
  32. Gandaglia G., Suardi N., Gallina A., Abdollah F., Capitanio U., Salonia A., Et al., Extended pelvic lymph node dissection does not affect erectile function recovery in patients treated with bilateral nerve-sparing radical prostatectomy, J Sex Med, 9, 8, pp. 2187-2194, (2012)
  33. Walz J., Epstein J.I., Ganzer R., Graefen M., Guazzoni G., Kaouk J., Et al., A critical analysis of the current knowledge of surgical anatomy of the prostate related to optimisation of cancer control and preservation of continence and erection in candidates for radical prostatectomy: An update, Eur Urol, 70, 2, pp. 301-311, (2016)
  34. Grande P., Di Pierro G.B., Mordasini L., Ferrari M., Wurnschimmel C., Danuser H., Et al., Prospective randomized trial comparing titanium clips to bipolar coagulation in sealing lymphatic vessels during pelvic lymph node dissection at the time of robot-assisted radical prostatectomy, Eur Urol, 71, 2, pp. 155-158, (2017)
  35. Eden C.G., Arora A., Rouse P., Extended vs standard pelvic lymphadenectomy during laparoscopic radical prostatectomy for intermediate-and high-risk prostate cancer, BJU Int, 106, 4, pp. 537-542, (2010)
  36. Tyritzis S.I., Wallerstedt A., Steineck G., Nyberg T., Hugosson J., Bjartell A., Et al., Thromboembolic complications in 3, 544 patients undergoing radical prostatectomy with or without lymph node dissection, J Urol, 193, 1, pp. 117-125, (2015)
  37. Schmitges J., Trinh Q.D., Jonas L., Budaus L., Larbig R., Schlomm T., Et al., Influence of low-molecular-weight heparin dosage on red blood cell transfusion, lymphocele rate and drainage duration after open radical prostatectomy, Eur J Surg Oncol, 38, 11, pp. 1082-1088, (2012)
  38. Boehm K., Beyer B., Tennstedt P., Schiffmann J., Budaeus L., Haese A., Et al., No impact of blood transfusion on oncological outcome after radical prostatectomy in patients with prostate cancer, World J Urol, 33, 6, pp. 801-806, (2015)
  39. Liss M.A., Palazzi K., Stroup S.P., Jabaji R., Raheem O.A., Kane C.J., Outcomes and complications of pelvic lymph node dissection during robotic-assisted radical prostatectomy, World J Urol, 31, 3, pp. 481-488, (2013)
  40. Violette P.D., Mikhail D., Pond G.R., Pautler S.E., Independent predictors of prolonged operative time during robotic-assisted radical prostatectomy, J Robot Surg, 9, 2, pp. 117-123, (2015)
  41. Van der Poel H.G., de Blok W., Tillier C., Van Muilekom E., Robot-assisted laparoscopic prostatectomy: Nodal dissection results during the first 440 cases by two surgeons, J Endourol, 26, 12, pp. 1618-1624, (2012)
  42. Schmitges J., Trinh Q.D., Sun M., Abdollah F., Bianchi M., Budaus L., Et al., Venous thromboembolism after radical prostatectomy: The effect of surgical caseload, BJU Int, 110, 6, pp. 828-833, (2012)
  43. Schmitges J., Trinh Q.D., Sun M., Abdollah F., Bianchi M., Budaus L., Et al., Annual prostatectomy volume is related to rectal laceration rate after radical prostatectomy, Urology, 79, 4, pp. 796-803, (2012)
  44. Touijer K., Fuenzalida R.P., Rabbani F., Paparel P., Nogueira L., Cronin A.M., Et al., Extending the indications and anatomical limits of pelvic lymph node dissection for prostate cancer: Improved staging or increased morbidity?, BJU Int, 108, 3, pp. 372-377, (2011)
  45. Yong D.Z., Tsivian M., Zilberman D.E., Ferrandino M.N., Mouraviev V., Albala D.M., Predictors of prolonged operative time during robot-assisted laparoscopic radical prostatectomy, BJU Int, 107, 2, pp. 280-282, (2011)
  46. Eifler J.B., Levinson A.W., Hyndman M.E., Trock B.J., Pavlovich C.P., Pelvic lymph node dissection is associated with symptomatic venous thromboembolism risk during laparoscopic radical prostatectomy, J Urol, 185, 5, pp. 1661-1665, (2011)
  47. Khoder W.Y., Trottmann M., Buchner A., Stuber A., Hoffmann S., Stief C.G., Et al., Risk factors for pelvic lymphoceles post-radical prostatectomy, Int J Urol, 18, 9, pp. 638-643, (2011)
  48. Lin B.M., Hyndman M.E., Steele K.E., Feng Z., Trock B.J., Schweitzer M.A., Et al., Incidence and risk factors for inguinal and incisional hernia after laparoscopic radical prostatectomy, Urology, 77, 4, pp. 957-962, (2011)
  49. Hruza M., Weiss H.O., Pini G., Goezen A.S., Schulze M., Teber D., Et al., Complications in 2200 consecutive laparoscopic radical prostatectomies: Standardised evaluation and analysis of learning curves, Eur Urol, 58, 5, pp. 733-741, (2010)
  50. Stolzenburg J.U., Rabenalt R., Do M., Ho K., Dorschner W., Waldkirch E., Et al., Endoscopic extraperitoneal radical prostatectomy: Oncological and functional results after 700 procedures, J Urol, 174, 4, pp. 1271-1275, (2005)
  51. Zorn K.C., Katz M.H., Bernstein A., Shikanov S.A., Brendler C.B., Zagaja G.P., Et al., Pelvic lymphadenectomy during robot-assisted radical prostatectomy: Assessing nodal yield, perioperative outcomes, and complications, Urology, 74, 2, pp. 296-302, (2009)
  52. Clark T., Parekh D.J., Cookson M.S., Chang S.S., Smith E.R., Wells N., Et al., Randomized prospective evaluation of extended versus limited lymph node dissection in patients with clinically localized prostate cancer, J Urol, 169, 1, pp. 145-147, (2003)
  53. Kim K.H., Lim S.K., Kim H.Y., Shin T.Y., Lee J.Y., Choi Y.D., Et al., Extended vs standard lymph node dissection in robot-assisted radical prostatectomy for intermediate- or high-risk prostate cancer: A propensity-score-matching analysis, BJU Int, 112, 2, pp. 216-223, (2013)
  54. Naselli A., Andreatta R., Introini C., Fontana V., Puppo P., Predictors of symptomatic lymphocele after lymph node excision and radical prostatectomy, Urology, 75, 3, pp. 630-635, (2010)
  55. Lindberg C., Davidsson T., Gudjonsson S., Hilmarsson R., Liedberg F., Bratt O., Extended pelvic lymphadenectomy for prostate cancer: Will the previously reported benefits be reproduced in hospitals with lower surgical volumes?, Scand J Urol Nephrol, 43, 6, pp. 437-441, (2009)
  56. Jung J.H., Seo J.W., Lim M.S., Lee J.W., Chung B.H., Hong S.J., Et al., Extended pelvic lymph node dissection including internal iliac packet should be performed during robot-assisted laparoscopic radical prostatectomy for high-risk prostate cancer, J Laparoendosc Adv Surg Tech A, 22, 8, pp. 785-790, (2012)
  57. Hoshi S., Hayashi N., Kurota Y., Hoshi K., Muto A., Sugano O., Et al., Comparison of semi-extended and standard lymph node dissection in radical prostatectomy: A single-institute experience, Mol Clin Oncol, 3, 5, pp. 1085-1087, (2015)
  58. Yuh B.E., Ruel N.H., Mejia R., Novara G., Wilson T.G., Standardized comparison of robot-assisted limited and extended pelvic lymphadenectomy for prostate cancer, BJU Int, 112, 1, pp. 81-88, (2013)
  59. Mistretta F.A., Boeri L., Grasso A.A., Lo Russo V., Albo G., DE Lorenzis E., Et al., Extended versus standard pelvic lymphadenectomy during robot-assisted radical prostatectomy: The role of extended template as an independent predictor of lymph node invasion with comparable morbidity burden, Minerva Urol Nefrol, 69, 5, pp. 475-485, (2017)
  60. Musch M., Klevecka V., Roggenbuck U., Kroepfl D., Complications of pelvic lymphadenectomy in 1, 380 patients undergoing radical retropubic prostatectomy between 1993 and 2006, J Urol, 179, 3, pp. 923-928, (2008)
  61. Klevecka V., Burmester L., Musch M., Roggenbuck U., Kroepfl D., Intraoperative and early postoperative complications of radical retropubic prostatectomy, Urol Int, 79, 3, pp. 217-225, (2007)
  62. Ostby-Deglum M., Brennhovd B., Axcrona K., Fossa S.D., Dahl A.A., A comparative study of erectile function and use of erectile aids in high-risk prostate cancer patients after robot-assisted laparoscopic prostatectomy, Scand J Urol, 49, 6, pp. 433-439, (2015)
  63. Hatzichristodoulou G., Wagenpfeil S., Wagenpfeil G., Maurer T., Horn T., Herkommer K., Et al., Extended versus limited pelvic lymph node dissection during bilateral nerve-sparing radical prostatectomy and its effect on continence and erectile function recovery: Long-term results and trifecta rates of a comparative analysis, World J Urol, 34, 6, pp. 811-820, (2016)
  64. Seikkula H., Janssen P., Tutolo M., Tosco L., Battaglia A., Moris L., Et al., Comparison of functional outcome after extended versus super-extended pelvic lymph node dissection during radical prostatectomy in high-risk localized prostate cancer, Front Oncol, 7, (2017)
  65. Ploussard G., Robotic surgery in urology: Facts and reality. What are the real advantages of robotic approaches for prostate cancer patients?, Curr Opin Urol, 28, 2, pp. 153-158, (2018)
  66. Gofrit O.N., Zorn K.C., Steinberg G.D., Zagaja G.P., Shalhav A.L., The will Rogers phenomenon in urological oncology, J Urol, 179, 1, pp. 28-33, (2008)
  67. Pagliarulo V., Hawes D., Brands F.H., Groshen S., Cai J., Stein J.P., Et al., Detection of occult lymph node metastases in locally advanced node-negative prostate cancer, J Clin Oncol, 24, 18, pp. 2735-2742, (2006)
  68. Berglund R.K., Sadetsky N., Duchane J., Carroll P.R., Klein E.A., Limited pelvic lymph node dissection at the time of radical prostatectomy does not affect 5-year failure rates for low, intermediate and high risk prostate cancer: Results from CaPSURE, J Urol, 177, 2, pp. 526-529, (2007)
  69. Karl A., Buchner A., Tympner C., Kirchner T., Ganswindt U., Belka C., Et al., Risk and timing of biochemical recurrence in pT3aN0/Nx prostate cancer with positive surgical margin - a multicenter study, Radiother Oncol, 116, 1, pp. 119-124, (2015)
  70. Gandaglia G., Ploussard G., Isbarn H., Suardi N., de Visschere P.J., Futterer J.J., Et al., What is the optimal definition of misclassification in patients with very low-risk prostate cancer eligible for active surveillance? Results from a multi-institutional series, Urol Oncol, 33, 4, (2015)
  71. Koo K.C., Tuliao P., Komninos C., Choi Y.D., Chung B.H., Hong S.J., Et al., Prognostic impact of time to undetectable prostate-specific antigen in patients with positive surgical margins following radical prostatectomy, Ann Surg Oncol, 22, 2, pp. 693-700, (2015)
  72. Mitsuzuka K., Koie T., Narita S., Kaiho Y., Yoneyama T., Kawamura S., Et al., Is pelvic lymph node dissection required at radical prostatectomy for low-risk prostate cancer?, Int J Urol, 20, 11, pp. 1092-1096, (2013)
  73. Masuda H., Fukushima H., Kawakami S., Numao N., Fujii Y., Saito K., Et al., Impact of advanced age on biochemical recurrence after radical prostatectomy in Japanese men according to pathological stage, Jpn J Clin Oncol, 43, 4, pp. 410-416, (2013)
  74. Daimon T., Miyajima A., Maeda T., Hattori S., Yasumizu Y., Hasegawa M., Et al., Does pelvic lymph node dissection improve the biochemical relapse-free survival in low-risk prostate cancer patients treated by laparoscopic radical prostatectomy?, J Endourol, 26, 9, pp. 1199-1202, (2012)
  75. Ost P., Cozzarini C., de Meerleer G., Fiorino C., de Potter B., Briganti A., Et al., High-dose adjuvant radiotherapy after radical prostatectomy with or without androgen deprivation therapy, Int J Radiat Oncol Biol Phys, 83, 3, pp. 960-965, (2012)
  76. Ku J.H., Jeong C.W., Park Y.H., Cho M.C., Kwak C., Kim H.H., Biochemical recurrence after radical prostatectomy with or without pelvic lymphadenectomy in Korean men with high-risk prostate cancer, Jpn J Clin Oncol, 41, 5, pp. 656-662, (2011)
  77. Weight C.J., Reuther A.M., Gunn P.W., Zippe C.R., Dhar N.B., Klein E.A., Limited pelvic lymph node dissection does not improve biochemical relapse-free survival at 10 years after radical prostatectomy in patients with low-risk prostate cancer, Urology, 71, 1, pp. 141-145, (2008)
  78. Bhatta-Dhar N., Reuther A.M., Zippe C., Klein E.A., No difference in six-year biochemical failure rates with or without pelvic lymph node dissection during radical prostatectomy in low-risk patients with localized prostate cancer, Urology, 63, 3, pp. 528-531, (2004)
  79. Fergany A., Kupelian P.A., Levin H.S., Zippe C.D., Reddy C., Klein E.A., No difference in biochemical failure rates with or without pelvic lymph node dissection during radical prostatectomy in low-risk patients, Urology, 56, 1, pp. 92-95, (2000)
  80. Preisser F., Van den Bergh R.C.N., Gandaglia G., Ost P., Surcel C.I., Sooriakumaran P., Et al., Effect of extended pelvic lymph node dissection on oncologic outcomes in patients with D’Amico intermediate and high risk prostate cancer treated with radical prostatectomy: A multi-institutional study, J Urol, 203, 2, pp. 338-343, (2020)
  81. Allaf M.E., Palapattu G.S., Trock B.J., Carter H.B., Walsh P.C., Anatomical extent of lymph node dissection: Impact on men with clinically localized prostate cancer, J Urol, 172, 5, pp. 1840-1844, (2004)
  82. Porter C.R., Suardi N., Capitanio U., Hutterer G.C., Kodama K., Gibbons R.P., Et al., A nomogram predicting prostate cancer-specific mortality after radical prostatectomy, Urol Int, 84, 2, pp. 132-140, (2010)
  83. Briganti A., Karnes J.R., da Pozzo L.F., Cozzarini C., Gallina A., Suardi N., Et al., Two positive nodes represent a significant cut-off value for cancer specific survival in patients with node positive prostate cancer. A new proposal based on a two-institution experience on 703 consecutive N+ patients treated with radical prostatectomy, extended pelvic lymph node dissection and adjuvant therapy, Eur Urol, 55, 2, pp. 261-270, (2009)
  84. Schumacher M.C., Burkhard F.C., Thalmann G.N., Fleischmann A., Studer U.E., Good outcome for patients with few lymph node metastases after radical retropubic prostatectomy, Eur Urol, 54, 2, pp. 344-352, (2008)
  85. Preisser F., Bandini M., Marchioni M., Nazzani S., Tian Z., Pompe R.S., Et al., Extent of lymph node dissection improves survival in prostate cancer patients treated with radical prostatectomy without lymph node invasion, Prostate, 78, 6, pp. 469-475, (2018)
  86. Sood A., Keeley J., Palma-Zamora I., Dalela D., Arora S., Peabody J.O., Et al., Extended pelvic lymph-node dissection is independently associated with improved overall survival in patients with prostate cancer at high-risk of lymph-node invasion, BJU Int, 125, 6, pp. 756-758, (2020)
  87. Messing E.M., Manola J., Yao J., Kiernan M., Crawford D., Wilding G., Et al., Immediate versus deferred androgen deprivation treatment in patients with node-positive prostate cancer after radical prostatectomy and pelvic lymphadenectomy, Lancet Oncol, 7, 6, pp. 472-479, (2006)
  88. Abdollah F., Karnes R.J., Suardi N., Cozzarini C., Gandaglia G., Fossati N., Et al., Impact of adjuvant radiotherapy on survival of patients with node-positive prostate cancer, J Clin Oncol, 32, 35, pp. 3939-3947, (2014)
  89. Abdollah F., Gandaglia G., Suardi N., Capitanio U., Salonia A., Nini A., Et al., More extensive pelvic lymph node dissection improves survival in patients with node-positive prostate cancer, Eur Urol, 67, 2, pp. 212-219, (2015)
  90. Fossati N., Parker W.P., Karnes R.J., Colicchia M., Bossi A., Seisen T., Et al., More extensive lymph node dissection at radical prostatectomy is associated with improved outcomes with salvage radiotherapy for rising prostate-specific antigen after surgery: A long-term, multi-institutional analysis, Eur Urol, 74, 2, pp. 134-137, (2018)
  91. Touijer K.A., Karnes R.J., Passoni N., Sjoberg D.D., Assel M., Fossati N., Et al., Survival outcomes of men with lymph node-positive prostate cancer after radical prostatectomy: A comparative analysis of different postoperative management strategies, Eur Urol, 73, 6, pp. 890-896, (2018)
  92. Ploussard G., Gandaglia G., Borgmann H., de Visschere P., Heidegger I., Kretschmer A., Et al., Salvage lymph node dissection for nodal recurrent prostate cancer: A systematic review, Eur Urol, 76, 4, pp. 493-504, (2019)
  93. Ploussard G., Almeras C., Briganti A., Giannarini G., Hennequin C., Ost P., Et al., Management of Node Only Recurrence after primary local treatment for prostate cancer: A systematic review of the literature, J Urol, 194, 4, pp. 983-988, (2015)
  94. Abdollah F., Briganti A., Montorsi F., Stenzl A., Stief C., Tombal B., Et al., Contemporary role of salvage lymphadenectomy in patients with recurrence following radical prostatectomy, Eur Urol, 67, 5, pp. 839-849, (2015)
  95. Passoni N.M., Suardi N., Abdollah F., Picchio M., Giovacchini G., Messa C., Et al., Utility of [11C]choline PET/CT in guiding lesion-targeted salvage therapies in patients with prostate cancer recurrence localized to a single lymph node at imaging: Results from a pathologically validated series, Urol Oncol, 32, 1, (2014)
  96. Bravi C.A., Fossati N., Gandaglia G., Suardi N., Mazzone E., Robesti D., Et al., Long-term outcomes of salvage lymph node dissection for nodal recurrence of prostate cancer after radical prostatectomy: Not as good as previously thought, Eur Urol, 78, 5, pp. 661-669, (2020)