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• W2091764179 abstract "You have accessJournal of UrologyProstate Cancer: Localized I1 Apr 2010291 STAGING IMPLICATIONS OF ANTERIOR PROSTATIC FAT PAD EXCISION DURING ROBOT-ASSISTED LAPAROSCOPIC RADICAL PROSTATECTOMY Jeongyun Jeong, Shilpa Lamba, Eun Yong Choi, Dong Il Kang, and Isaac Yi Kim Jeongyun JeongJeongyun Jeong New Brunswick, NJ More articles by this author , Shilpa LambaShilpa Lamba New Brunswick, NJ More articles by this author , Eun Yong ChoiEun Yong Choi New Brunswick, NJ More articles by this author , Dong Il KangDong Il Kang Busan, Republic of Korea More articles by this author , and Isaac Yi KimIsaac Yi Kim New Brunswick, NJ More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.353AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Lymph node status has significant implications for management following radical prostatectomy. Presently, pelvic lymph node dissection is the recommended procedure for staging, but additional lymph node sites may be of clinical significance. We performed anterior prostatic fat (APF) pad excision during robot-assisted laparoscopic radical prostatectomy (RALRP) in an effort to seek the staging implications of the excision. METHODS A total of 258 consecutive patients underwent APF pad excision procedure during RALRP between July 2007 and June 2009. Additionally, National Comprehensive Cancer Network (NCCN) guideline was used to determine the necessity of pelvic lymph node dissections. After performing each APF pad dissection during RALRP, we collected the specimen and submitted en bloc to the pathology department where it was evaluated for the presence of lymphoid tissue and metastatic prostate cancer. Retrospective chart review was performed for each of the 258 patients who underwent RALRP with APF excision and pathological analysis. Perioperative patient characteristics including PSA and prostate biopsy Gleason scores as well as surgical pathology results were analyzed. RESULTS Of the 258 consecutive patients, 30 (11.6%) were found to have 1 or 2 APF pad lymph nodes and 228 (88.4%) men showed no lymphoid tissue in their APF pads. In the perioperative patient characteristics, mean PSA level was the only parameter which showed significant difference between the two groups. The distribution of patients according to the pathological stage and grade demonstrated statistically no significant difference between the two groups. Among the 30 patients with APF pad lymph nodes, 3 patients had nodes positive for metastatic prostate cancer cells. Of note, all 3 had high-risk preoperative features with biopsy Gleason scores greater than 7 and/or PSA scores greater than 20ng/ml. In 1 of these 3 patients, the cancer was upstaged secondary to detection of positive APF pad lymph nodes with negative pelvic lymph nodes. At 2-year follow-up, PSA level of this patient remains undetectable. CONCLUSIONS In this study, we demonstrated that the APF pad contained lymph nodes in over 11% of the time and the dissection of the APF pad enhanced more accurate pathologic staging. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e115 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jeongyun Jeong New Brunswick, NJ More articles by this author Shilpa Lamba New Brunswick, NJ More articles by this author Eun Yong Choi New Brunswick, NJ More articles by this author Dong Il Kang Busan, Republic of Korea More articles by this author Isaac Yi Kim New Brunswick, NJ More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2091764179 title "291 STAGING IMPLICATIONS OF ANTERIOR PROSTATIC FAT PAD EXCISION DURING ROBOT-ASSISTED LAPAROSCOPIC RADICAL PROSTATECTOMY" @default.
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