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Pelvic lymph node dissection

Giorgio Gandaglia, Carlo Andrea Bravi, Paolo Dell'Oglio, Elio Mazzone, Nicola Fossati, Simone Scuderi, Daniele Robesti, Francesco Barletta, Luca Grillo, Steven Maclennan, James N'Dow, Francesco Montorsi, Alberto Briganti
The rate of postoperative complications might vary according to the method used to collect perioperative data. We aimed at assessing the impact of the prospective implementation of the European Association of Urology (EAU) guidelines on reporting and grading of complications in prostate cancer patients undergoing robot-assisted radical prostatectomy (RARP). From September 2016, an integrated method for reporting surgical morbidity based on the EAU guidelines was implemented at a single, tertiary center. Perioperative data were prospectively and systematically collected during a patient interview at 30 d after surgery as recommended by the EAU Guidelines Panel Recommendations on Reporting and Grading Complications...
March 12, 2018: European Urology
Ioannis Lilis, Ioanna Giopanou, Helen Papadaki, Kostis Gyftopoulos
BACKGROUND: Mammalian target of rapamycin (mTOR) is a central regulator of major cellular processes such as growth and proliferation. Deregulated mTOR signaling is implicated in a wide spectrum of human malignancies including prostate cancer. The aim of this study is to address the role of phosphorylated mTOR (p-mTOR) in prostate adenocarcinoma-induced lymphangiogenesis and lymph node metastasis as well as to investigate its relationship with chicken ovalbumin upstream promoter transcriptional factor 2 (COUP-TFII) and the vascular endothelial growth factors A/C (VEGF A/C)...
March 12, 2018: Urologic Oncology
Sou Hirose, Hiroshi Tanabe, Youko Nagayoshi, Yukihiro Hirata, Chikage Narui, Kazuhiko Ochiai, Seiji Isonishi, Hirokuni Takano, Aikou Okamoto
OBJECTIVE: The aim of the study is to investigate recurrence of stage I epithelial ovarian cancer. METHODS: Six hundred two patients diagnosed with stage I epithelial ovarian cancer at 4 hospitals between 2000 and 2013 were retrospectively analyzed. Age, surgical procedure, substage, histologic type, adjuvant chemotherapy, recurrence, initial recurrence site (peritoneal dissemination [P], hematogenous recurrence [H], lymphogenous recurrence [L], and others [O]), and frequency of recurrence at each site were investigated retrospectively...
February 6, 2018: Journal of Gynecologic Oncology
Hisanaga Horie, Koji Koinuma, Homare Ito, Ai Sadatomo, Daishi Naoi, Yoshihiko Kono, Yoshiyuki Inoue, Mitsuaki Morimoto, Makiko Tahara, Alan K Lefor, Naohiro Sata, Takahiro Sasaki, Hideharu Sugimoto
INTRODUCTION: Laparoscopic lateral pelvic lymph node dissection (LPLD) is technically challenging because of the complicated anatomy of the pelvic wall. To overcome this difficulty, we introduced preoperative 3-D simulation. The aim of the study is to investigate the usefulness of preoperative 3-D simulation for the safe conduct of laparoscopic LPLD for rectal cancer. METHODS: After undergoing colonoscopy, patients were brought to the radiology suite where multi-detector row CT was performed...
March 12, 2018: Asian Journal of Endoscopic Surgery
Michael Höckel, Sophia Trott, Nadja Dornhöfer, Lars-Christian Horn, Bettina Hentschel, Benjamin Wolf
BACKGROUND: The incidence of vulvar cancer is increasing, but surgical treatment-the current standard of care-often leads to unsatisfactory outcomes, especially in patients with node-positive disease. Preliminary results at our centre showed that locoregional spread of vulvar carcinoma occurs within tissue domains defined by stepwise embryonic and fetal development (ontogenetic cancer fields and associated lymph node regions). We propose that clinical translation of these insights into practice could improve outcomes of surgical treatment of vulvar cancer...
March 9, 2018: Lancet Oncology
Berk Hazır, Hakan Bahadır Haberal, Devrim Akıncı, Bülent Akdoğan
INTRODUCTION: A pelvic lymphocele is a collection of lymphatic fluid that develops after extensive lymphadenectomies in surgeries such as urological malignancies or renal transplantation. Pelvic lymphoceles may cause complications such as fever, abdominal pain, leg swelling, genital swelling and flank pain. This report summarizes the management of a pelvic lymphocele after open radical retropubic prostatectomy with bilateral lymphadenectomy. PRESENTATION OF CASE: Herein, we present a case in which a pelvic lymphocele developed seven months post-radical open retropubic prostatectomy and through this patient we discussed the lymphocele following radical prostatectomy...
March 6, 2018: International Journal of Surgery Case Reports
Arjun Sivaraman, Nicole Benfante, Karim Touijer, Jonathan Coleman, Peter Scardino, Vincent Laudone, James Eastham
Purpose: To verify the quality of pelvic lymph node dissection (PLND) performed at radical prostatectomy (RP) and its impact on nodal recurrence in patients undergoing salvage lymph node dissection (sLND). Materials and Methods: Retrospective review of 48 patients who underwent sLND for presumed nodal recurrence, to describe the PLND characteristics at RP and correlate the anatomical sites and number of suspicious nodes reported in radiological imaging and final pathology of sLND...
March 2018: Investigative and Clinical Urology
Catrin von Below, Cecilia Wassberg, Rafael Grzegorek, Joel Kullberg, Charlotta Gestblom, Jens Sörensen, Mauritz Waldén, Håkan Ahlström
Background: The aim of the study was to examine the value of quantitative and qualitative MRI and11 C acetate PET/CT parameters in predicting regional lymph node (LN) metastasis of newly diagnosed prostate cancer (PCa). Patients and methods: Patients with intermediate (n = 6) and high risk (n = 47) PCa underwent 3T MRI (40 patients) and11 C acetate PET/CT (53 patients) before extended pelvic LN dissection. For each patient the visually most suspicious LN was assessed for mean apparent diffusion coefficient (ADCmean), maximal standardized uptake value (SUVmax), size and shape and the primary tumour for T stage on MRI and ADCmean and SUVmax in the index lesion...
March 2018: Radiology and Oncology
Sıtkı Ün, Hakan Türk, Ahmet Selçuk Dindar, Ferruh Zorlu
Introduction: Radical cystectomy (RC) is the standard treatment model in invasive bladder cancer patients. Risk definitions before RC is mainly based on pathological results. Neutrophil/lymphocyte (N/L) rate is one of the inflammation markers. Some other studies reported negative prognostic results with increased N/L rates. In our study, we reviewed the relationship between preoperative N/L rate and clinicopathological results following RC. Materials and Methods: Data gathered from 296 bladder cancer patients that received RC between 2002 and 2012 were retrospectively reviewed...
January 2018: Journal of Cancer Research and Therapeutics
Kazuhiro Kitajima, Shingo Yamamoto, Soichi Odawara, Yusuke Kawanaka, Yukako Nakanishi, Takahiko Hashimoto, Yusuke Yamada, Toru Suzuki, Akihiro Kanematsu, Michio Nojima, Neinei Kimura, Masataka Zouzumi, Seiichi Hirota, Koichiro Yamakado
We report a 65-year-old male with histopathologically proven prostate cancer and multiple pelvic node metastases using a robotic-assisted radical prostatectomy procedure plus extended pelvic lymph node dissection. Positron emission tomography (PET) scan findings demonstrated a moderate accumulation of11 C-choline in a metastatic left obturator node sized 8 × 8 mm, though only a faint uptake of fluorodeoxyglucose (FDG) was noted.11 C-choline PET/computed tomography (CT) may be useful for the diagnosis of a tiny metastatic lymph node not demonstrated by CT, magnetic resonance imaging, or FDG-PET/CT and to determine the need for an extended pelvic lymph node dissection...
January 2018: Case Reports in Oncology
Volkan Tuğcu, Oktay Akça, Abdulmuttalip Şimşek, İsmail Yiğitbaşı, Mustafa Gürkan Yenice, Selçuk Şahin, Ali İhsan Taşcı
Objective: To describe The Tugcu Bakirkoy robotic perineal radical prostatectomy and pelvic lymph node dissection technique, and present the results of seven patients. Material and methods: We performed seven robotic perineal radical prostatectomy and pelvic lymph node dissection operation using Da Vinci Xi HD Surgical System (Intuitive Surgical, Inc., Sunnyvale, California, USA) on single Gel-port platform. The operation is completed in 4 stages: stage 1 open perineal dissection and gel port placement, stage 2 robotic perineal radical prostatectomy, stage 3 robotic pelvic lymph node dissection, stage 4 vesico-urethral anastomosis...
March 2018: Turkish Journal of Urology
Elisabeth J Diver, Emily M Hinchcliff, Allison A Gockley, Alexander Melamed, Leah Contrino, Sarah Feldman, Whitfield B Growdon
OBJECTIVE: This study aims to understand the treatment patterns and clinical outcomes of older women with cervical cancer compared to younger women. METHODS: Women undergoing care for cervical cancer between 2000 and 2013 at two academic institutions were identified. The cohort of older patients was defined as >65 years old at diagnosis. Patient charts were retrospectively reviewed, and clinical variables were extracted. Fisher's exact tests, logistic regression, and Kaplan-Meier analyses were performed...
March 1, 2018: Journal of Geriatric Oncology
Mikel Gorostidi, Cecilia Villalain, Ruben Ruiz, Ibon Jaunarena, Arantxa Lekuona, Irene Diez
STUDY OBJECTIVE: To determine the importance of a dual (cervical and fundal) indocyanine green (ICG) injection and a thorough dissection for the detection of sentinel lymph node (SLN). DESIGN: Step-by-step description of a surgical procedure using video (Canadian Task Force III) SETTING: Hospital Universitario Donostia (Spain). PATIENTS: A 60-year-old woman with a diagnosis of IAG1 endometrial adenocarcinoma (EC). INTERVENTIONS: The patient underwent a cervical and transcervical fundal ICG injection for paraortic and pelvic SLN detection in the setting of a research protocol and a total hysterectomy and bilateral salpingo-oophorectomy with frozen section of the uterus as standard approach (1)...
March 1, 2018: Journal of Minimally Invasive Gynecology
Tomohiro Tate, Yudai Fukui, Kenji Tomizawa, Yutaka Hanaoka, Shigeo Toda, Shuichiro Matoba, Hiroya Kuroyanagi
BACKGROUND: The local recurrence of rectal cancer classifies 4 types, anterior, posterior, lateral compartment and anastomotic site. This study evaluates outcome of laparoscopic lateral lymph node dissection(LLND)against the lateral lymph node recurrence. METHOD: Five patients were diagnosed as the lateral lymph node recurrence and underwent laparoscopic LLND. We diagnosed the lateral lymph node recurrence by CT, MRI and PET-CT. All cases revealed abnormal uptake on PET-CT...
February 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Kazuhiro Sakamoto, Makoto Takahashi, Rina Takahashi, Shingo Kawano, Masaya Kawai, Kiichi Sugimoto, Hirohiko Kamiyama, Yutaka Kojima, Atsushi Okuzawa, Yuichi Tomiki
Here, we report a case of repeated laparoscopic resection of extra-regional lymph node metastases in a patient after laparoscopic surgery for rectal cancer. A 72-year-old woman was diagnosed with upper rectal cancer and underwent laparoscopic low anterior resection and D3 dissection. The pathological stage was considered as T3, N2b, M0, Stage IIIC. Six months after the operation, positron emission tomography-computed tomography (PET-CT) showed fluorodeoxyglucose (FDG) accumulation in the infra-renal para-aortic lymph nodes (PALNs)...
April 2018: Journal of Minimal Access Surgery
Francesco Porpiglia, Matteo Manfredi, Fabrizio Mele, Riccardo Bertolo, Enrico Bollito, Dario Gned, Agostino De Pascale, Filippo Russo, Roberto Passera, Cristian Fiori, Stefano De Luca
BACKGROUND: The Briganti updated nomogram (BN) is the most popular predictive model aiming to predict the presence of lymph node invasion (LNI) in patients with prostate cancer (PCa), but it lacks information obtained by preoperative imaging. The primary aim of the study was to evaluate the role of multiparametric prostate magnetic resonance imaging (mp-MRI) in the indication to perform pelvic lymph nodes dissection (PLND) or not in patients with risk of LNI according to BN below 5%. METHODS: Since March 2012 and September 2016, 310 patients who underwent a preoperative mp-MRI for staging purpose and subsequent robot-assisted extended PLND (RAEPLND) were retrospectively evaluated...
February 22, 2018: Prostate Cancer and Prostatic Diseases
F Abdollah, S Arora, T Jindal, P Gild, A Sood, T B Yuvaraja, R K Ahlawat, N P Gupta, M Bhandari, M Menon
BACKGROUND: The utilization and extent of pelvic lymph node dissection (PLND) varies depending on the disease and practice patterns. AIMS: This study compares practice patterns in utilization of PLND between Indian and United States (US) practices. SETTINGS AND DESIGN: We focused on 415 patients (204 India; 211 US) prostate cancer patients treated with robot-assisted radical prostatectomy, between 2015 and 2016, within the Vattikuti Collective Quality Initiative database...
April 2017: Indian Journal of Cancer
Matthias M Heck, Margitta Retz, Miriam Bandur, Marc Souchay, Elisabeth Vitzthum, Gregor Weirich, Tibor Schuster, Michael Autenrieth, Hubert Kübler, Tobias Maurer, Mark Thalgott, Kathleen Herkommer, Jürgen E Gschwend, Roman Nawroth
PURPOSE: Molecular lymph node (LN) analysis using quantitative polymerase chain reaction (qPCR) detects LN metastases with higher sensitivity than histopathology. However, the prognostic role of molecular LN status in prostate cancer (PCa) patients treated with radical prostatectomy (RP) and extended pelvic LN dissection (ePLND) is unclear. To investigate the association of molecular compared to histopathologic LN status with biochemical recurrence. EXPERIMENTAL DESIGN: Patients with intermediate and high risk PCa were prospectively enrolled and underwent RP with ePLND including obturator, internal, external and common iliac region...
February 20, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Felix Preisser, Marco Bandini, Michele Marchioni, Sebastiano Nazzani, Zhe Tian, Raisa S Pompe, Nicola Fossati, Alberto Briganti, Fred Saad, Shahrokh F Shariat, Hans Heinzer, Hartwig Huland, Markus Graefen, Derya Tilki, Pierre I Karakiewicz
PURPOSE: To assess the effect of pelvic lymph node dissection (PLND) extent on cancer-specific mortality (CSM) in prostate cancer (PCa) patients without lymph node invasion (LNI) treated with radical prostatectomy (RP). METHODS: Within the Surveillance, Epidemiology, and End results (SEER) database (2004-2014), we identified patients with D'Amico intermediate- or high-risk characteristics who underwent RP with PLND, without evidence of LNI. First, multivariable logistic regression models tested for predictors of more extensive PLND, defined as removed lymph node count (NRN) ≥75th percentile...
February 19, 2018: Prostate
Muammer Altok, Kara Babaian, Mary F Achim, Grace C Achim, Patricia Troncoso, Surena F Matin, Brian F Chapin, John W Davis
OBJECTIVES: To evaluate the peri-operative, pathologic, and oncologic outcomes from surgeon led pathologic staging of pelvic lymph node metastases at the time of robot-assisted radical prostatectomy (RARP). PATIENTS AND METHODS: Over the 6-year period of 2006-2012, three distinct pelvic lymph node dissection strategies were utilized in chronologic order at a single cancer referral hospital. Strategies were characterized by both a 1) omission of PLND versus inclusion decision threshold, and 2) standard versus extended templates for patients selected for PLND...
February 15, 2018: BJU International
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