Radical retropubic prostatectomy for prostate cancer with pelvic lymph node metastasis.
- Author:
Ding-Yi LIU
1
;
Sang HU
2
;
Yan-Feng ZHOU
1
;
Hong-Chao HE
3
;
Jia-Shun YU
1
;
Jian WANG
1
;
Wei-Mu XIA
1
;
Qi TANG
1
;
Ming-Wei WANG
3
;
Wen-Long ZHOU
3
Author Information
1. Department of Urology, Shanghai Punan Hospital, Shanghai 200125, China.
2. Department of Urology, Shanghai Youdian Hospital, Shanghai 200040, China.
3. Department of Urology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.
- Publication Type:Journal Article
- Keywords:
lymph node metastasis;
radical retropubic prostatectomy;
prostate cancer
- MeSH:
Androgen Antagonists;
therapeutic use;
Antigens, Surface;
metabolism;
Chemotherapy, Adjuvant;
Glutamate Carboxypeptidase II;
metabolism;
Humans;
Lymph Node Excision;
Lymph Nodes;
pathology;
Lymphatic Metastasis;
Male;
Pelvis;
Postoperative Period;
Prostate-Specific Antigen;
metabolism;
Prostatectomy;
methods;
Prostatic Neoplasms;
drug therapy;
metabolism;
surgery
- From:
National Journal of Andrology
2017;23(11):982-986
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the safety and effectiveness of radical retropubic prostatectomy (RRP) with adjuvant androgen deprivation or external radiotherapy in the treatment of prostate cancer (PCa) with pelvic lymph node metastasis (PLNM).
METHODS:Twenty PCa patients underwent bilateral pedal lymphangiography (PLG) preoperatively, and 11 of them received lymph node aspiration for examination of the mRNA expressions of prostate-specific antigen (PSA) and prostate-specific membrane antigen (PSMA) in the lymph fluid by real-time RT-PCR. All the patients were treated by RRP with extended dissection of pelvic lymph nodes, and 3 of them by external radiotherapy in addition after recovery from urinary incontinence because of positive surgical margins, followed by adjuvant androgen deprivation therapy.
RESULTS:Real-time RT-PCR showed positive mRNA expressions of PSA and PSMA in the lymph fluid of the 11 patients, all pathologically confirmed with PLNM. The median intraoperative blood loss was 575 ml, with blood transfusion for 5 cases. Positive surgical margin was found in 3 cases, lymphorrhagia in 2 and urinary leakage in another 2 each. There were no such severe complications as vascular injury and rectum perforation. The patients were followed up for 6－48 (mean 42) months, during which, biochemical recurrence was observed in 12 cases at a median of 12 months postoperatively and 2 patients died at 12 and 48 months respectively.
CONCLUSIONS:Bilateral PLG and lymph node aspiration for examination of the mRNA expressions of PSA and PSMA in the lymph fluid help to confirm PLNM preoperatively. Radical retropubic prostatectomy with adjuvant androgen deprivation or external radiotherapy is safe and effective for the treatment of PCa with PLNM, but it should be chosen cautiously for those with Gleason 5+5.
