OBJECTIVES: Pelvic lymph node metastases indicate a poor prognosis for prostate cancer patients. The aim of this study was to evaluate the suitability of laparoscopic radioisotope guided sentinel lymph node (SLN) dissection in staging of prostate carcinoma. METHODS: 28 patients with prostate cancer and intermediate or high risk for lymph node metastases considered for external beam radiotherapy underwent laparoscopic pelvic lymphadenectomy at our institution. For visualization of individual SLN distribution, an image fusion system consisting of a gamma-camera with integrated X-ray tube was used. During laparoscopic lymphadenectomy, SLN were identified using a laparoscopic gamma probe. RESULTS: Preoperative imaging and laparoscopic gamma probe allowed an excellent delineation of SLN. 57% (preoperative imaging) as well as 48% (intraoperative measurements) of SLN were found outside the obturator fossa. All SLN were removed successfully without intra- or postoperative complications. Despite extended lymphadenectomy, no significant lymphocele appeared. 10 lymph node metastases were found in 7 out of the 31 patients (23%) with 3 of the 10 metastases lying outside the obturator fossa representing the standard lymphadenectomy area. CONCLUSIONS: The present data demonstrate that laparoscopic SLN dissection is an excellent minimally invasive and technically feasible tool for staging of intermediate and high risk prostate cancer.
OBJECTIVES: Pelvic lymph node metastases indicate a poor prognosis for prostate cancerpatients. The aim of this study was to evaluate the suitability of laparoscopic radioisotope guided sentinel lymph node (SLN) dissection in staging of prostate carcinoma. METHODS: 28 patients with prostate cancer and intermediate or high risk for lymph node metastases considered for external beam radiotherapy underwent laparoscopic pelvic lymphadenectomy at our institution. For visualization of individual SLN distribution, an image fusion system consisting of a gamma-camera with integrated X-ray tube was used. During laparoscopic lymphadenectomy, SLN were identified using a laparoscopic gamma probe. RESULTS: Preoperative imaging and laparoscopic gamma probe allowed an excellent delineation of SLN. 57% (preoperative imaging) as well as 48% (intraoperative measurements) of SLN were found outside the obturator fossa. All SLN were removed successfully without intra- or postoperative complications. Despite extended lymphadenectomy, no significant lymphocele appeared. 10 lymph node metastases were found in 7 out of the 31 patients (23%) with 3 of the 10 metastases lying outside the obturator fossa representing the standard lymphadenectomy area. CONCLUSIONS: The present data demonstrate that laparoscopic SLN dissection is an excellent minimally invasive and technically feasible tool for staging of intermediate and high risk prostate cancer.
Authors: David Schilling; Ulf Boekeler; Georgios Gakis; Christian Schwentner; Stefan Corvin; Karl Sotlar; Arndt-Christian Müller; Roland Bares; Arnulf Stenzl Journal: World J Urol Date: 2010-03-27 Impact factor: 4.226
Authors: Lenka Vermeeren; Willem Meinhardt; Henk G van der Poel; Renato A Valdés Olmos Journal: Eur J Nucl Med Mol Imaging Date: 2010-07-09 Impact factor: 9.236
Authors: Stephen P Povoski; Ryan L Neff; Cathy M Mojzisik; David M O'Malley; George H Hinkle; Nathan C Hall; Douglas A Murrey; Michael V Knopp; Edward W Martin Journal: World J Surg Oncol Date: 2009-01-27 Impact factor: 2.754
Authors: L Vermeeren; R A Valdés Olmos; W Meinhardt; A Bex; H G van der Poel; W V Vogel; F Sivro; C A Hoefnagel; S Horenblas Journal: Eur J Nucl Med Mol Imaging Date: 2009-03-14 Impact factor: 9.236