ArticleThe Journal of urology2023
Unilateral Pelvic Lymph Node Dissection in Prostate Cancer Patients Diagnosed in the Era of Magnetic Resonance Imaging-targeted Biopsy: A Study That Challenges the Dogma.
Article in The Journal of urology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed, 21 citations in OpenAlex.
- Tumor Laterality Predicts Pelvic Lymph Node Metastasis Patterns in Bladder Cancer.Annals of surgical oncology · 2026Article
- ASO Author Reflections: Tumor Laterality as a Key Determinant of Pelvic Lymph Node Dissection Strategy in Bladder Cancer.Annals of surgical oncology · 2026Article
- Psychosocial distress after radical prostatectomy, radical cystectomy, or (partial) nephrectomy - a comprehensive analysis of 4,290 German cancer patients during the COVID-19 pandemic.Journal of cancer survivorship : research and practice · 2026Article
- Prediction of Contralateral Lymph Node Involvement during Extended Pelvic Lymph Node Dissection for Clinically Unilateral Prostate Cancer.Annals of surgical oncology · 2026Article
- Metastatic lymph nodes outside the extended lymphadenectomy template correlate with advanced staging but not grading in prostate cancer patients undergoing radical prostatectomy.International urology and nephrology · 2025Article
- External validation of an algorithm to personalize nerve sparing approaches during robot-assisted radical prostatectomy in men with unilateral high-risk prostate cancer.Prostate cancer and prostatic diseases · 2025Article
- Optimization of Extended Pelvic Lymph Node Dissection Side for Prostate Cancer.Annals of surgical oncology · 2024Article
- From foes to friends: rethinking the role of lymph nodes in prostate cancer.Nature reviews. Urology · 2024Review
- An updated model for predicting side-specific extraprostatic extension in the era of MRI-targeted biopsy.Prostate cancer and prostatic diseases · 2024Article
- Pelvic Lymph Node Dissection: A Comparison Among Extraperitoneal Single-port and Transperitoneal Multiport Radical Prostatectomy-A Single-center Experience.European urology open science · 2024Article
- Review
- Analysis of biopsy pathology and risk factors of lymph node metastasis in prostate cancer.International urology and nephrology · 2024Article
- Association of Lymphovascular Invasion with Lymph Node Metastases in Prostate Cancer-Lateralization Concept.Cancers · 2024Article
- Progress of fluorescence imaging in lymph node dissection surgery for prostate and bladder cancer.Frontiers in oncology · 2024Review
- Can contralateral lymph-node metastases be ruled out in prostate cancer patients with only unilaterally positive prostate biopsy?International journal of clinical oncology · 2023Article
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44 authors at 18 institutions in 9 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeBilateral extended pelvic lymph node dissection at the time of radical prostatectomy is the current standard of care if pelvic lymph node dissection is indicated; often, however, pelvic lymph node dissection is performed in pN0 disease. With the more accurate staging achieved with magnetic resonance imaging-targeted biopsies for prostate cancer diagnosis, the indication for bilateral extended pelvic lymph node dissection may be revised MATERIALS AND
methodsWe analyzed a multi-institutional data set of men with cN0 disease diagnosed by magnetic resonance imaging-targeted biopsy who underwent prostatectomy and bilateral extended pelvic lymph node dissection. The outcome of the study was lymph node invasion contralateral to the prostatic lobe with worse disease features, ie, dominant lobe. Logistic regression to predict lymph node invasion contralateral to the dominant lobe was generated and internally validated.
resultsOverall, data from 2,253 patients were considered. Lymph node invasion was documented in 302 (13%) patients; 83 (4%) patients had lymph node invasion contralateral to the dominant prostatic lobe. A model including prostate-specific antigen, maximum diameter of the index lesion, seminal vesicle invasion on magnetic resonance imaging, International Society of Urological Pathology grade in the nondominant side, and percentage of positive cores in the nondominant side achieved an area under the curve of 84% after internal validation. With a cutoff of contralateral lymph node invasion of 1%, 602 (27%) contralateral pelvic lymph node dissections would be omitted with only 1 (1.2%) lymph node invasion missed.
conclusionsPelvic lymph node dissection could be omitted contralateral to the prostate lobe with worse disease features in selected patients. We propose a model that can help avoid contralateral pelvic lymph node dissection in almost one-third of cases.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.