Prevalence of High-Risk Prostate Cancer Metastasis to Cloquet's Ilioinguinal Lymph Node.

Autor:	Plata Bello A; University Hospital of Canary Islands, Tenerife, Spain., Apatov SE; Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.; Department of Surgical Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia., Benfante NE; Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York., Rivero Belenchón I; Department of Urology, Virgen del Rocio University Hospital, Sevilla, Spain., Picola Brau N; Department of Urology, Bellvitge University Hospital, Barcelona, Spain., Mercader Barrull C; Department of Urology, Hospital Clinic of Barcelona, Barcelona, Spain., Jenjitranant P; Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.; Division of Urology, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand., Vickers AJ; Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York., Fine SW; Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York., Touijer KA; Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
Jazyk:	angličtina
Zdroj:	The Journal of urology [J Urol] 2022 Jun; Vol. 207 (6), pp. 1222-1226. Date of Electronic Publication: 2022 Jan 20.
DOI:	10.1097/JU.0000000000002439
Abstrakt:	Purpose: Cloquet's node, located at the junction between the deep inguinal nodes and the external iliac chain, is easily accessible and commonly excised during pelvic lymph node dissection for prostate cancer. However, we hypothesize that Cloquet's node is not part of lymphatic metastatic spread of prostate cancer. Materials and Methods: Between September 2016 and June 2019, 105 consecutive patients with high-risk prostate cancer (cT3a or Grade Group 4/5, or prostate specific antigen >20 ng/ml) underwent a laparoscopic radical prostatectomy and pelvic lymph node dissection. First, Cloquet's node was identified, retrieved and submitted separately to pathology as right and left Cloquet's node. Next, a pelvic lymph node dissection was completed including the external iliac, obturator fossa and hypogastric nodal packets. Each lymph node was cut into 3 mm slices which were separately embedded in paraffin, stained with hematoxylin and eosin, and examined microscopically. Results: The final analysis included 95 patients. In this high-risk population, the median number of nodes removed was 22 (IQR 18-29); 39/95 patients (41%) had lymph node metastasis. The median number of Cloquet's nodes removed was 2 (IQR 2-3). Cloquet's node was negative in all but 1 patient (1.1%), who had very high-risk features and high metastatic burden in the lymph nodes. Conclusions: In high-risk prostate cancer, metastasis to the ilioinguinal node of Cloquet is rare. Given this low prevalence, Cloquet's node can be safely excluded from the pelvic lymph node dissection template.
Databáze:	MEDLINE
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