Radiation after pelvic lymphadenectomy: effect on morbidity.
The role of a staging pelvic lymph node dissection has been questioned because of its associated morbidity, especially when followed by definitive radiation therapy. Forty-nine patients with clinically localized adenocarcinoma of the prostate underwent a staging pelvic lymphadenectomy. Clinically suspected lymph nodes were submitted for frozen section analysis. A unilateral dissection was performed on 7 patients (14%), none of whom developed intraoperative or postoperative complications. The remaining 42 patients underwent bilateral pelvic lymphadenectomy, after which 26 were treated with definitive radiation therapy using the four-field box technique, and 16 received other forms of therapy (delayed androgen deprivation or hormonal manipulation). The complication rate of 19% was identical for both groups of patients. Complications consisted of 3 seromas, 1 atelectasis, 1 prolonged ileus, 1 wound infection, and 2 transient penile or scrotal edemas. Radiation therapy, therefore, did not increase postoperative morbidity.
D000135:Acid Phosphatase / Q000097:blood; D000230:Adenocarcinoma / Q000201:enzymology / Q000601:surgery*; D000368:Aged; D003131:Combined Modality Therapy; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011471:Prostatic Neoplasms / Q000201:enzymology / Q000601:surgery*; D011878:Radiotherapy / Q000009:adverse effects*
D000135:Acid Phosphatase