Complications and Other Surgical Outcomes Associated with Extended Pelvic Lymphadenectomy in Men with Localized Prostate Cancer

Alberto Briganti, Felix K H Chun, Andrea Salonia, Nazareno Suardi, Andrea Gallina, Luigi Filippo Da Pozzo, Marco Roscigno, Giuseppe Zanni, Luc Valiquette, Patrizio Rigatti, Francesco Montorsi, Pierre I. Karakiewicz

Research output: Contribution to journalArticle

Abstract

Objectives: More-extensive pelvic lymph node dissection (PLND) may be associated with a higher rate of complications and a longer hospital stay than more limited PLND. Methods: Before radical retropubic prostatectomy, PLNDs were performed in 963 patients. Of these, 767 (79.6%) had ≥10 lymph nodes removed and examined (extended PLND [ePLND]), while 1-9 nodes (limited PLND [lPLND]) were removed in the remaining 196 (20.4%). Limits included external iliac, obturator, internal iliac, and iliac bifurcation. PLND-related complications and the length of hospital stay were recorded prospectively and analyzed according to the extent of PLND. Results: In patients subjected to ePLND, the overall rate of complications was 19.8% versus 8.2% in those treated with lPLND (p <0.001). In individual analyses of specific complications, only the lymphocele rate was significantly higher after ePLND (10.3% vs 4.6%; p = 0.01). Similarly, ePLND translated into a longer hospital stay (9.9 vs 8.2 d; p <0.001). These differences persisted when adjustment was made for prostate-specific antigen and either clinical or pathologic tumor characteristics. Conclusions: Our data indicate that, even in the hands of experienced urologic surgeons, ePLNDs are associated with higher complication rates and longer hospital stay. These detriments need to be taken into account when the staging benefit associated with ePLND is considered.

Original languageEnglish
Pages (from-to)1006-1013
Number of pages8
JournalEuropean Urology
Volume50
Issue number5
DOIs
Publication statusPublished - Nov 2006

Keywords

  • Complications
  • Pelvic lymphadenectomy
  • Prostate cancer
  • Radical prostatectomy

ASJC Scopus subject areas

  • Urology

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