医学
前列腺切除术
前列腺癌
淋巴结
谷氨酸羧肽酶Ⅱ
解剖(医学)
淋巴
泌尿科
正电子发射断层摄影术
前列腺特异性抗原
前列腺
放射科
癌症
肿瘤科
内科学
病理
作者
Lukas Lunger,Lisa Steinhelfer,Philipp Korn,Matthias Eiber,Tobias Maurer,Jakob Büchler,Thomas Horn,Jürgen E. Gschwend,Matthias Heck
标识
DOI:10.1016/j.euo.2022.12.001
摘要
Lymph node metastases (LNMs) are common in intermediate- to high-risk prostate cancer (PC) and may be missed during extended pelvic lymph node dissection (ePLND). Here we report on the use of prostate-specific membrane antigen (PSMA)-radioguided surgery (RGS) during open radical prostatectomy (RP) with ePLND to resect locoregional LNMs identified on preoperative PSMA positron emission tomography (PET). Preoperative PSMA PET showed 78 LNMs in 35 patients undergoing RP with ePLND and RGS between January 2018 and June 2020. In 14 patients (40%), LNMs were located outside the ePLND template. RGS achieved resection of PSMA-positive LNMs in 33/35 patients (94%). On univariable analysis, lower metastatic burden with up to two PSMA-positive LNMs on preoperative PET was associated with better postoperative outcomes. Limitations include the retrospective analysis and the small sample size. RGS facilitates resection of PSMA-positive LNs in patients treated with RP. Our data indicate a favorable treatment outcome in patients with low metastatic LN burden on preoperative PSMA PET. PATIENT SUMMARY: We investigated the use of radioactive guidance to remove lymph nodes affected by prostate cancer during surgical removal of the prostate. This approach can help to identify cancerous lymph nodes that might otherwise be missed and could lead to better survival outcomes.
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