Fossati, et al. (2017). Retrosperctive study. (Meta-analysis) Oncological outcomes by 29 studies (1414 Fossati N, Willemse PM, Van den Broeck T, van den Bergh RCN, Yuan CY, Briers E, et al. The Benefits and Harms of Different Extents of Lymph Node Dissection During Radical Prostatectomy for Prostate Cancer: A Systematic Review. Eur Urol. 2017; 72:84-109.). |
-Experimental arm and one control arm; Studies with more than two arms T1-3 N0 M0 PCa |
lPLND vs. ePLND vs. sePLND |
ORP, RARP, LRP |
D'amico risk: -Low -Intermediate -High |
NA
|
CSS, BCR
|
-
|
Choo, at el. (2017). Retrospective study. (Meta-analysis). 2004-2014 (4646 Choo MS, Kim M, Ku JH, Kwak C, Kim HH, Jeong CW. Extended versus Standard Pelvic Lymph Node Dissection in Radical Prostatectomy on Oncological and Functional Outcomes: A Systematic Review and Meta-Analysis. Ann Surg Oncol. 2017; 24:2047-54.). |
Seven studies include to oncology outcomes results 1095 p. |
sPLND vs. ePLND |
RARP, ORP |
D'amico risk: -Intermediate -High |
NA
|
BCR (HR 0.71, 95% CI 0.56-0.90, p = 0.005) |
+
|
Preisser (2017). Retrospective 2004-2014 (4444 Preisser F, Bandini M, Marchioni M, Nazzani S, Tian Z, Pompe RS, et al. Extent of lymph node dissection improves survival in prostate cancer patients treated with radical prostatectomy without lymph node invasion. Prostate. 2018; 78:469-75.). (SEER) database. |
28147 patients. |
lPLND (75%) vs. ePLND (24,8%) |
NA |
Gleason - ≤6: 2238 (8%) - 7: 19374 (68.8) - ≥8: 6535 (23.2%) Intermediate risk -18942 (67.3%) High risk -9205 (32.7%) |
Median PSA (IQR) 6.5 (4.8-10) |
N°LN: > 11 nodes removed improve 6-years PCa-specific survival (99.5% vs 98.1%, p: 0,014) CSM-free:ePLND: HR of 0.52 (C.I. 0.30-0.89, P = 0.017). |
+
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García-Perdomo et al. (2018). (Meta-analysis) (4545 García-Perdomo HA, Correa-Ochoa JJ, Contreras-García R, Daneshmand S. Effectiveness of extended pelvic lymphadenectomy in the survival of prostate cancer: a systematic review and meta-analysis. Cent European J Urol. 2018; 71:262-9.). Retrospective study. |
4 studies were included to study BRFS. |
Pca N0M0 sPLND vs. ePLND |
RAPR (1 study), ORP (3 studies) |
In Two studies: -Low, intermediate and high risk. In other two studies: -Intermediate and high risk |
NA
|
BRFS Favours ePLND HR = 0.62, 95% CI (0.36, 0.87) |
+
|
Huele at al. (2018). Retrospective study (5353 Van Huele A, Poelaert F, Fonteyne V, Decaestecker K, Ost P, Lumen N. Pelvic lymph node dissection in prostate cancer staging: evaluation of morbidity and oncological outcomes. Acta Chir Belg. 2019; 119:103-9.). 2000-2016 |
228 p. (9 patients were excluded). Roach formula: 2/3 x prostate-specific antigen [PSA]+[Gleason score - 6]x10 (7575 Stolzenburg JU, Arthanareeswaran VKA, Dietel A, Franz T, Liatsikos E, Kyriazis I, et al. Four-point Peritoneal Flap Fixation in Preventing Lymphocele Formation Following Radical Prostatectomy. Eur Urol Oncol. 2018; 1:443-8.) |
Staging PLND before primary RT in a single tertiary care center |
ORP (50), LPP (96), RARP(73) |
Risk group classification: -Intermediate: 41 (18.8%) -High: 126 (57.8%) -Very high (locally advanced): 51 (23.4%) |
NA
|
BCR, CSS, OS
|
-
|
Furubayashi et al. (2019). Retrospective single center study (4747 Furubayashi N, Negishi T, Uozumi T, Shiraishi K, Taguchi K, Shimokawa M, et al. Eliminating microscopic lymph node metastasis by performing pelvic lymph node dissection during radical prostatectomy for prostate cancer. Mol Clin Oncol. 2020; 12:104-10.). 1998-2013. |
348 patients T1-3 N0 M0 PCa. |
sPLND (70.9%,247/348) vs ePLND (29.1%,101/348) |
ORP (100%) |
-Gleason: ≤7 sPLND 171 (69.2%), ePLND 70 (69.3%) -Gleason: >8 PLND 76 (30.8%), ePLND 31 (30.7%) -N°Lymph N. sPLND: 13 (0-31), ePLND: 19 (5-40) |
Median PSA: - 8.171 ng/mL (range, 0.8 to 39.413 ng/mL - PSA ≤10: sPLND 170 (68.8%) vs. ePLND 50 (49.5) - PSA >10: sLPND: 77 (31.2%) vs ePLND: 51 (50.5%) |
N° LN, PSA failure |
+
|
Chen et al. (2019). Retrospective study (5050 Chen J, Wang Z, Zhao J, Zhu S, Sun G, Liu J, et al. Pelvic lymph node dissection and its extent on survival benefit in prostate cancer patients with a risk of lymph node invasion >5%: a propensity score matching analysis from SEER database. Sci Rep. 2019; 9:17985.). SEER database 2010-2015 |
20,668 patients. |
No PLND vs. PLND- |
NA |
D'Amico risk stratifcation, n (%) -Low NPLND 366 (8.6%) PLND 369 (2.3%) - Intermediate. NPLND 2658 (62.3%) PLND 7463 (45.5%) - High. NPLND 1243p (29.1%) PLND 8569p (52.2%) |
PSa ≤20: -NPLND: 4039 (94.7%) -PLND: 14462 (88.2%) PSA >20: -NPLDN 228 (5.3%) -PLND 1939 (11.8%) |
CSS (5-year CSS rate: 99.4% vs. 99.7%, p=0.479) |
-
|
Tomisaki et al. (2019) 2004 – 2011. No comparative Retrospective Single center study (5252 Tomisaki I, Ikuta H, Higashijima K, Onishi R, Minato A, Fujimoto N. Oncological Outcome After Radical Prostatectomy without Pelvic Lymph Node Dissection for Localized Prostate Cancer: Follow-up Results in a Single Institution. Cancer Invest. 2019; 37:524-30.). |
Consecutive 146 patients (RP without PLND); - MSKCC nomogram |
No PLND |
NA |
Gleason score < 6: 61p, 3+4: 42p., 4+3: 15p. >8: 28 p. D'Amico classification Low: 39 p., Intermediate: 59 p., High: 48 p. |
Initial PSA: - 7.6 ng/mL Median (IQR): - 7.6 (5.5-12.2) |
BCR (Not inferior to others reports) |
-
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Sood et al. (2020). Retrospective study (4848 Sood A, Keeley J, Palma-Zamora I, Dalela D, Arora S, Peabody JO, et al. Extended pelvic lymph-node dissection is independently associated with improved overall survival in patients with prostate cancer at high-risk of lymph-node invasion. BJU Int. 2020; 125:756-8.) 2004-2015 National Cancer Database (NCDB). |
311.061 P -Risk was calculated using the Godoy-nomogram. Follow-up was 54.0 (31.3-79.9) |
lPLND or No PLND (84,1%) vs. ePLND (15,9%); N°Lymph Node (m) lPLND 2 vs. ePLND 14. |
NA |
D'Amico Intermediate and high rick prostate cancer. |
Median PSA: lPLND psa: 5ng/mL vs ePLND psa: 6 ng/mL |
CSS 7% incremental benefit in 10-year CSS per every additional LN removed (P = 0.02). |
+
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Preisser et al. (2020). Retrospective study (5151 Preisser F, van den Bergh RCN, Gandaglia G, Ost P, Surcel CI, Sooriakumaran P, et al. Effect of Extended Pelvic Lymph Node Dissection on Oncologic Outcomes in Patients with D'Amico Intermediate and High Risk Prostate Cancer Treated with Radical Prostatectomy: A Multi-Institutional Study. J Urol. 2020; 203:338-43.). Multi-institutional data base (4 centers). 2000- 2017. |
9.742 p. |
No PLND vs. PLND A median of 14 lymph nodes (IQR 8-21) were removed. |
NA |
D'Amico intermediate and high risk prostate cancer. |
NA |
BRFR 60.4% vs 65.6% (p=0.07) SMFS 95.2% vs 96.4% (p=0.2). |
-
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Lestigni et al. (2020). Prospective fase III study(4949 Lestingi JFP, Guglielmetti GB, Trinh QD, Coelho RF, Pontes J Jr, Bastos DA, et al. Extended Versus Limited Pelvic Lymph Node Dissection During Radical Prostatectomy for Intermediate- and High-risk Prostate Cancer: Early Oncological Outcomes from a Randomized Phase 3 Trial. Eur Urol. 2020: S0302-2838; 30941-6.). 2012-2016 |
300 p. median follow-up (61,4 months) Pca (> cT2b or > PSA 10 ng/mL or Gleason score >7) |
ePLND vs lPLND (1:1). RP N°LN: ePLND (mean) 17 n. vs lPLND (mean) 3 n. |
RARP (100%) |
D'Amico Intermediate and High risk prostate cancer. |
Median PSA, ng/mL (IQR): ePLND 10.5 (6.5-17) vs lPLND 10.4 (6.9-13.9) |
BRFS. (HR 0.91, 95% CI 0.63-1.32, p = 0.6) Subgroup (short time analysis) BRFS was better: biopsy ISUP GG3–GG5 who underwent ePLND |
-
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