Indocyanine green guidance improves the efficiency of extended pelvic lymph node dissection during laparoscopic radical prostatectomy
| Autor: | Juan Casanova Ramón-Borja, Ana Calatrava Fons, Francesco Claps, Maria Carmen Mire Maresma, Carlo Trombetta, Álvaro Gómez-Ferrer, Argimiro Collado Serra, Jose Marenco, José Rubio-Briones, J.M. Mascarós, Miguel Ramírez-Backhaus |
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| Přispěvatelé: | Claps, Francesco, Ramírez-Backhaus, Miguel, Mire Maresma, Maria Carmen, Gómez-Ferrer, Álvaro, Mascarós, Juan Manuel, Marenco, Josè, Collado Serra, Argimiro, Casanova Ramón-Borja, Juan, Calatrava Fons, Ana, Trombetta, Carlo, Rubio-Briones, Jose |
| Rok vydání: | 2020 |
| Předmět: |
Biochemical recurrence
Indocyanine Green Male medicine.medical_specialty Laparoscopic radical prostatectomy Urology medicine.medical_treatment Sentinel lymph node 030232 urology & nephrology Pelvis prostatic neoplasm 03 medical and health sciences sentinel lymph node 0302 clinical medicine medicine Humans Lymph node Prostatectomy business.industry Prostatic Neoplasms pelvic lymph node dissection radical prostatectomy fluorescence prostatic neoplasms Dissection Lymphatic system medicine.anatomical_structure 030220 oncology & carcinogenesis Lymph Node Excision Laparoscopy Lymph Lymph Nodes business |
| Zdroj: | International journal of urology : official journal of the Japanese Urological AssociationReferences. 28(5) |
| ISSN: | 1442-2042 |
| Popis: | OBJECTIVES: To evaluate whether indocyanine green guidance can improve the quality of extended pelvic lymph node dissection in patients undergoing radical prostatectomy. METHODS: A total of 214 patients underwent laparoscopic radical prostatectomy with indocyanine green-guided lymph node dissection plus extended pelvic lymph node dissection. These patients (group A) were matched 1:1 for clinical risk groups according to the National Comprehensive Cancer Network classification with patients who underwent the same procedure without fluorescence guidance (group B). Biochemical recurrence was defined as two consecutive prostate-specific antigen rises of at least 0.2 ng/mL. The Kaplan-Meier method and Cox regression models were used to identify predictors of biochemical recurrence. RESULTS: The median number of retrieved nodes was significantly higher in group A (22 vs 14, P < 0.001). The rate of lymph node metastases was higher in group A (65.9% vs 34.1%, P = 0.01). Increasing the yield of lymph node dissection was independently and negatively correlated with the biochemical recurrence risk in both overall and pN-positive patients (hazard ratio 0.97, P = 0.03; and hazard ratio 0.95, P = 0.02). The 5-year biochemical recurrence-free survival rates were (75.8% vs 65.9, P = 0.09) and (54.1% vs 24.9%, P = 0.023) for group A and group B in the overall cohort and pN-positive cohort, respectively. CONCLUSION: Indocyanine green-guided lymph node dissection plus extended pelvic lymph node dissection improves identification of lymphatic drainage, resulting in a higher number of lymph nodes and retrieved lymph node metastases, and allowing a more accurate local staging and a prolonged biochemical recurrence-free survival. |
| Databáze: | OpenAIRE |
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