The role of lymphadenectomy in high risk prostate cancer
The role of lymphadenectomy in high risk prostate cancer
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DOI：
10.1007/s00345-008-0251-6
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发表时间：
2008-06-01
影响因子：
3.4
通讯作者：
Studer, Urs E.
中科院分区：
文献类型：
--
作者：
Burkhard, Fiona C.;Studer, Urs E.
从历史上看，由于盆腔淋巴结阳性的可能性和长期生存率下降，高危前列腺癌患者被认为是根治性前列腺切除术（RP）的不佳候选人。尽管对于这类患者的最佳治疗方法仍没有达成共识，但越来越多的证据表明手术可能发挥作用。根据肿瘤分化程度，RP治疗局部晚期疾病后10年随访的癌症特异性生存率（CSS）范围为29%至72%。盆腔淋巴结清扫术（PLND）在前列腺癌中的作用仍然是一个有争议的话题。尽管如此，应结合RRP进行扩展PLND（ePLND），因为扩展淋巴结清扫代替标准PLND可能会提高分期准确性，影响辅助治疗的决策，并可能影响结局。患有器官局限性前列腺癌和低体积（微）转移性疾病的高风险患者可能是从这种方法中获益最多的患者。
Historically, patients with high risk prostate cancer were considered poor candidates for radical prostatectomy (RP) due to the likelihood of positive pelvic lymph nodes and decreased long term survival. Although there is still no consensus on the optimal therapy for this group of patients, there is increasing evidence that surgery could play a role. Cancer specific survival (CSS) rates after RP for locally advanced disease at 10 year follow up range from 29 to 72%, depending on tumor differentiation. The role of pelvic lymph node dissection (PLND) in prostate cancer remains a controversial topic. Nonetheless, in conjunction with RRP extended PLND (ePLND) should be performed as extended lymph node dissection in lieu of standard PLND may increase staging accuracy, influence decision making with respect to adjuvant therapy and possibly impact outcome. High risk patients with organ confined prostate cancer and low volume (micro)metastatic disease may be the ones to profit most from this approach.