Linfadenectomía pélvica extendida en pacientes con cáncer de próstata clínicamente localizado: estudio observacional prospectivo

Published on Sep 1, 2016in Actas Urologicas Espanolas0.994
· DOI :10.1016/J.ACURO.2016.02.002
José Gustavo Ramos2
Estimated H-index: 2
(Pontifical Xavierian University),
Juan Ignacio Caicedo6
Estimated H-index: 6
(University of Los Andes)
+ 4 AuthorsMauricio Plata7
Estimated H-index: 7
(University of Los Andes)
Sources
Abstract
Resumen Objetivo Determinar la frecuencia de compromiso ganglionar en pacientes con adenocarcinoma de prostata clinicamente localizado llevados a prostatectomia radical y linfadenectomia pelvica extendida. Material y metodos Se realizo un estudio observacional prospectivo con 137 pacientes con cancer de prostata clinicamente localizado, de riesgo bajo, intermedio y alto segun la clasificacion de D’Amico. Todos los sujetos fueron llevados a prostatectomia radical mas linfadenectomia pelvica extendida en 3 centros de referencia en Bogota, Colombia, entre los anos 2013 a 2014. Se evaluaron las siguientes variables: edad, PSA, Gleason de la biopsia, probabilidad de compromiso ganglionar por tablas de Partin, y el resultado histopatologico del especimen quirurgico con el patron de Gleason definitivo y el total de ganglios resecados y comprometidos por el tumor, de acuerdo al territorio de la diseccion. Resultados Se extrajeron un total de 2.876 ganglios, en promedio 20,99 ganglios por paciente. Se encontro compromiso ganglionar en 14 (10,22%) pacientes. El grupo de riesgo alto e intermedio presentaron metastasis ganglionares en el 28,57% y el 5,25% respectivamente. No hubo compromiso ganglionar en el grupo de bajo riesgo. De los pacientes con un riesgo de compromiso ganglionar ≥ 2%, segun las tablas de Partin, el 19,40% presento metastasis ganglionares. Conclusion El compromiso ganglionar en nuestra poblacion es similar al reportado en la literatura mundial. La linfadenectomia pelvica extendida aumento la probabilidad de deteccion de metastasis ganglionares en nuestro medio.
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view all 11 authors...
Resumen Introduccion La linfadenectomia en el cancer de prostata (CP) es el procedimiento mas fiable para la deteccion de metastasis linfaticas. La extension optima de la misma aun es un tema en debate. Objetivo Analizar el rendimiento diagnostico y las complicaciones de la linfadenectomia ampliada (LFDNA) y limitada (LFDNL) en una serie de pacientes con CP de alto riesgo sometidos a prostatectomia radical (PR). Material y metodos Estudio retrospectivo de pacientes con CP de alto riesgo de D’Ami...
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Abstract Objective To analyze the correlation between pathological data found in radical prostatectomy and previously performed biopsy in patients at low risk prostate cancer. Material and methods A descriptive, cross-sectional study was conducted to assess the characteristics of radical prostatectomies performed in our center from January 2012 to November 2014. The inclusion criteria were patients with low-risk disease (cT1c–T2a, PSA ≤ 10 ng/ml and Gleason score ≤ 6). We excluded patients who h...
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Resumen Objetivo Analizar la correlacion entre los datos anatomopatologicos encontrados en prostatectomia radical y la biopsia previa realizada en pacientes con cancer de prostata de bajo riesgo. Material y metodos Se ha realizado un estudio descriptivo transversal para valorar las caracteristicas de las prostatectomias radicales realizadas en nuestro centro desde enero de 2012 a noviembre de 2014. Los criterios de inclusion fueron pacientes con enfermedad de bajo riesgo (cT1c-T2a, PSA ≤ 10 ng/m...
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BACKGROUND Accurate staging is important before surgical decision in patients with high-risk prostate cancer (PCa). The purpose of this study was to prospectively compare the diagnostic performance of 18F-FCholine and MRI with diffusion weighted imaging (DWIMRI) for local and regional lymph node (LN) staging before radical prostatectomy (RP) with extended pelvic lymphadenectomy (PLND). METHODS We identified 47 patients who underwent 18F-FCholine and DWIMRI followed by surgical treatment (either ...
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Abstract Context The most recent summary of the European Association of Urology (EAU) guidelines on prostate cancer (PCa) was published in 2011. Objective To present a summary of the 2013 version of the EAU guidelines on screening, diagnosis, and local treatment with curative intent of clinically organ-confined PCa. Evidence acquisition A literature review of the new data emerging from 2011 to 2013 has been performed by the EAU PCa guideline group. The guidelines have been updated, and levels of...
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Purpose: We investigated the incremental value of magnetic resonance imaging in addition to clinical variables for predicting pathological outcomes and disease recurrence in patients with clinically high risk prostate cancer.Materials and Methods: A total of 922 consecutive patients with clinically high risk prostate cancer underwent magnetic resonance imaging before radical prostatectomy. We created multivariate logistic regression and Cox proportional hazards models with clinical variables onl...
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Objective To update the 2007 Partin tables in a contemporary patient population. Patients and Methods The study population consisted of 5,629 consecutive men who underwent RP and staging lymphadenectomy at the Johns Hopkins Hospital between January 1, 2006 and July 30, 2011 and met inclusion criteria. Polychotomous logistic regression analysis was used to predict the probability of each pathologic stage category: organ-confined disease (OC), extraprostatic extension (EPE), seminal vesicle involv...
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Purpose: The 2011 NCCN (National Comprehensive Cancer Network) guidelines for prostate cancer recommend pelvic lymph node dissection at radical prostatectomy in all individuals with a nomogram predicted lymph node invasion probability of 2% or greater. We examined the ability of these guidelines to correctly predict lymph node invasion in patients treated with extended pelvic lymph node dissection.Materials and Methods: We examined 3,064 consecutive patients treated with radical prostatectomy an...
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Cited By1
Newest
#2Rodolfo Varela (National University of Colombia)H-Index: 3
#3Carlos CéspedesH-Index: 1
Last. Juanita González (National University of Colombia)
view all 5 authors...
Introduccion y Objetivos La linfadenectomia pelvica ampliada es el metodo mas confiable para identificar compromiso ganglionar en cancer de prostata, sin embargo, la morbilidad, el tiempo quirurgico, el papel terapeutico y las complicaciones, han sido temas de debate. El objetivo del estudio fue describir las caracteristicas clinicas y patologicas de acuerdo con la presentacion de recaida bioquimica de los pacientes con cancer de prostata de bajo riesgo tratados con prostatectomia radical mas li...
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