Borkowetz, Angelika and Bruendl, Johannes and Drerup, Martin and Herrmann, Jonas and Isbarn, Hendrik and Beyer, Burkhard (2018) Multicenter evaluation of guideline adherence for pelvic lymph node dissection in patients undergoing open retropubic vs. laparoscopic or robot assisted radical prostatectomy according to the recent German S3 guideline on prostate cancer. WORLD JOURNAL OF UROLOGY, 36 (6). pp. 855-861. ISSN 0724-4983, 1433-8726
Full text not available from this repository. (Request a copy)Abstract
Pelvic lymph node dissection (PLND) is recommended for patients with prostate cancer (PCa) and significant risk for nodal metastases. This study aimed to assess guideline adherence regarding PLND according to the German S3 guideline as example for a national but highly used guideline on prostate cancer and to compare the rate of complications different approaches for radical prostatectomy (RP). Patients undergoing open (RRP), laparoscopic (LARP) or robot-assisted (RARP) RP in six centers in Germany and Austria were included. The primary endpoint was the total number of removed lymph nodes (LN) between the different surgical approaches according to recent guideline recommendations. Secondary endpoints were the number of patients undergoing a sufficient PLND, defined as a removal of at least 10 LN and associated complication rates. 2634 patients undergoing RP were included (RRP: 66%, RARP/LARP: 34%). PLND was performed in 88% (RRP: 88.5%, RARP/LARP: 86.8%, p = 0.208). In intermediateor high risk PCa, PLND was performed in 97.2% (RRP: 97.7%, RARP/LARP: 96.2, p = 0.048). Of those, the mean number of LN was 19 (RRP: 19 vs. RARP/LARP: 17, p < 0.005) and sufficient PLND was observed in 84.6% of RRP compared to 77.2% of RARP/LARP (p < 0.005). Symptomatic lymphoceles requiring surgical treatment occurred more often in RRP than in RARP/LARP (4.0% vs. 1.6%, p = 0.001). The general guideline adherence regarding performing PNLD and the LN yield is high, regardless of the surgical approach. As expected, lymph node yield was higher when very experienced surgeons conducted the procedure. This should be considered in patients' counseling.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ESTRO-SIOG GUIDELINES; LYMPHADENECTOMY; COMPLICATIONS; EXTENT; MEN; RISK; RECOMMENDATIONS; INTERMEDIATE; SURVIVAL; INVASION; Pelvic lymph node dissection; Guidelines; Adherence; Prostate cancer; Prostatectomy |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Urologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 20 Feb 2020 08:35 |
| Last Modified: | 20 Feb 2020 08:35 |
| URI: | https://pred.uni-regensburg.de/id/eprint/14526 |
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