Pelvic lymphadenectomy for radical prostatectomy: perioperative and oncological results

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Abstract

Background. Currently, in men suffering from prostate cancer, histological examination of the material obtained during pelvic lymphadenectomy (PLAE) is the most accurate and reliable method for staging the tumor process and postoperative prognosis of disease outcomes, an important factor influencing the choice of the most rational treatment tactics after radical prostatectomy. However, today questions about the therapeutic (oncological) expediency of PLAE and its safety in terms of the development of intra- and postoperative complications remain debatable.

Aim. To was to compare the perioperative and therapeutic (oncological) results of radical prostat ectomy performed in combination with standard or extended PLAE.

Materials and methods. The study materials were the data of medical records of 812 men aged 43 to 78 years, at different times (from January 2009 to December 2018) who were hospitalized for localized or locally advanced prostate cancer in stages cT1a–cT3bN0M0. The research method was a retrospective analysis of the data contained in the selected medical records.

Results and conclusion. The results of our studies, firstly, confirm the conclusions of the European Association of Urology (EAU) experts on the justification and necessity of performing an extended PLAE with radical prostatectomy in order to diagnose metastatic lesions of the pelvic lymph nodes in individuals with an intermediate or high risk of prostate cancer progression; secondly, they indicate a higher therapeutic efficacy of extended PLAE compared to that for standard PLAE, which is expressed in a statistically significantly three times lower incidence of biochemical relapses and an 11.4 % longer relapse-free period after extended PLAE than after standard PLAE. Extended PLAE, performed in one surgical session with radical prostatectomy, is not a risk factor for the development of various intra- and postoperative complications, with the exception of the lymphocele, which is formed in 3.7–13.5 % of cases of extended PLAE due to intraoperative transection of lymphatic vessels and lymph accumulation at the site of the removed adipose tissue.

About the authors

S. V. Popov

St. Luka’s Clinical Hospital

Email: doc.popov@gmail.com
ORCID iD: 0000-0003-2767-7153

46 Chugunnaya St., Saint Petersburg 194044

Russian Federation

R. G. Guseynov

St. Luka’s Clinical Hospital; Saint Petersburg State University

Email: rusfa@yandex.ru
ORCID iD: 0000-0001-9935-0243

Department of Hospital Surgery, SPSU

46 Chugunnaya St., Saint Petersburg 194044; 7–9 Universitetskaya Naberezhnaya, Saint Petersburg 199034

Russian Federation

I. N. Orlov

St. Luka’s Clinical Hospital; I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia

Email: doc.orlov@gmail.com
ORCID iD: 0000-0001-5566-9789

46 Chugunnaya St., Saint Petersburg 194044; 47 Piskarevskiy Prospekt, Saint Petersburg 195067

Russian Federation

O. N. Skryabin

St. Luka’s Clinical Hospital

Email: skryabin_55@mail.ru
ORCID iD: 0000-0002-6664-2861

46 Chugunnaya St., Saint Petersburg 194044

Russian Federation

V. V. Perepelitsa

St. Luka’s Clinical Hospital

Email: perepelitsa_vit@mail.ru
ORCID iD: 0000-0002-7656-4473

46 Chugunnaya St., Saint Petersburg 194044

Russian Federation

А. S. Katunin

St. Luka’s Clinical Hospital

Author for correspondence.
Email: aleksandrkatunin@gmail.com
ORCID iD: 0000-0003-3676-6246

46 Chugunnaya St., Saint Petersburg 194044

Russian Federation

M. M. Mirzabekov

St. Luka’s Clinical Hospital

Email: muramura450h@gmail.com
ORCID iD: 0000-0001-5792-1589

46 Chugunnaya St., Saint Petersburg 194044

Russian Federation

A. S. Zaytsev

St. Luka’s Clinical Hospital

Email: zaitsevurology@gmail.com
ORCID iD: 0000-0002-4651-8142

46 Chugunnaya St., Saint Petersburg 194044

Russian Federation

S. Yu. Yasheva

St. Luka’s Clinical Hospital

Email: yashevasofi@mail.ru
ORCID iD: 0000-0001-7918-3580

46 Chugunnaya St., Saint Petersburg 194044

Russian Federation

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