Role of Pelvic Lymph Node Dissection in Prostate Cancer Treatment
정재영, 조인창, 이강현,
소속 상세정보
정재영 ( Joung Jae-Young )
National Cancer Center Center for Prostate Cancer
조인창 ( Cho In-Chang )
National Cancer Center Center for Prostate Cancer
이강현 ( Lee Kang-Hyun )
National Cancer Center Center for Prostate Cancer
KMID : 0358320110520070437
Abstract
Pelvic lymph node dissection (PLND) is the most accurate and reliable staging procedure for detecting lymph node invasion (LNI) in prostate cancer. Recently, [11C]-choline positron emission tomography imaging and magnetic resonance imaging with lymphotropic superpara-magnetic nanoparticles have shown potential for detecting LNI but are still under investigation. The risk of LNI in low-risk groups could be underestimated by use of the current nomograms, which rely on data collected from patients who underwent only limited PLND. Extended PLND (ePLND) shows higher lymph node yield, which leads to the removal of more positive nodes and fewer missed positive nodes. It may be possible to refrain from performing PLND on low-risk patients with a prostate-specific antigen value <10 ng/ml and a biopsy Gleason score ≤6, but the risk of biopsy-related understaging should be kept in mind. Theoretically, meticulous ePLND may also impact prostate cancer survival by clearing low-volume diseases and occult micrometastasis even in pN0. The therapeutic role of PLND in prostate cancer patients is still an open question, especially in individuals with low-risk disease. Patients with intermediate- to high-risk disease are more likely to benefit from ePLND.
키워드
Lymph node dissections; Prostate cancer; Prostatectomy
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