Clinical Geriatrics - Short Communications
Published: 2018-12-15

Robot-assisted pelvic lymphadenectomy for prostate cancer. Potentially advantageous in the elderly?

Urology and Renal Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy
Urology and Renal Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy
Department of Clinical and Experimental Medicine, University of Foggia, Italy
Urology and Renal Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy
Department of Urology, Institut Montsouris, Paris, France
Urology and Renal Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy
Elderly Prostate cancer Radical Prostatectomy ymphadenectomy robotic surgery open surgery

Abstract

Background and aims. Pelvic lymphadenectomy is the most effective method for the detection of lymph
node metastases due to prostate cancer. Question remains whether robot-assisted pelvic lymphadenectomy
provides the same number of nodes than open lymphadenectomy. We compared outcomes and number of
nodes retrieved by the two procedures.
Methods. Data of patients who had undergone pelvic lymphadenectomy during robot-assisted radical prostatectomy (Group A) between January 2016 and June 2018 were compared to those of a matched population having undergone pelvic lymphadenectomy during open retropubic prostatectomy (Group B).
Results. The median number of removed lymph nodes was 11 (range 8-15) in Group A and 14 (range 12-16)
in Group B (p = 0.05) but the rate of N+ patients was 11.4% in Group A and 14.7% in group B (p = 0.3). The
median number of metastatic lymph nodes was 1 (range 1-1) in Group A and 2.2 (range 1-9) in Group B. There
was no vascular complication but the rate of lymphocele requiring percutaneous drainage was 9% in Group B
as opposed to none in Group A (p = 0.12) and mean age of patients suffering this complication was 70y.
Conclusions. Robot-assisted pelvic lymphadenectomy provided a lower number of nodes than the open approach but this did not significantly change the number of patients diagnosed as N+. Though more time-consuming, the robotic approach avoided pelvic lymphoceles which were seen in almost 10% of patients having
undergone the open approach. The risk of such complication appeared to be related to age.

Affiliations

M. Di Nauta

Urology and Renal Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy

L. Cormio

Urology and Renal Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy

R. Villani

Department of Clinical and Experimental Medicine, University of Foggia, Italy

V. Mancini

Urology and Renal Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy

E. Barret

Department of Urology, Institut Montsouris, Paris, France

G. Carrieri

Urology and Renal Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy

Copyright

© Società Italiana di Gerontologia e Geriatria (SIGG) , 2018

How to Cite

[1]
Di Nauta, M., Cormio, L., Villani, R., Mancini, V., Barret, E. and Carrieri, G. 2018. Robot-assisted pelvic lymphadenectomy for prostate cancer. Potentially advantageous in the elderly?. JOURNAL OF GERONTOLOGY AND GERIATRICS. 66, 4 (Dec. 2018), 195-199.
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