title: Analysis of regional lymph nodes in periprostatic fat following robot-assisted radical prostatectomy.
abstract: OBJECTIVE
  • To determine the incidence and significance of lymph nodes in the anterior prostatovesicular lymphofatty tissue.
  
  
  METHODS
  • One hundred and twenty patients with clinically localized prostate cancer underwent robot-assisted laparoscopic radical prostatectomy with excision of anterior prostatovesicular tissue at a single institution over a 6-month period. • Tissue was sent for pathological analysis. • Separate pelvic lymph node dissection was carried out in moderate-risk and high-risk patients.
  
  
  RESULTS
  • A total of 20 out of 120 patients (16.7%) had lymph nodes in the anterior lymphofatty tissue. • Average lymph node number when present was 1.5 (one to three). • Pathological assessment of the lymph nodes revealed metastatic prostate cancer in 3 out of 120 (2.5%) patients, each of whom had adverse pathological features. • Patients with metastatic lymph nodes in the anterior tissue did not have cancer involvement of the pelvic lymph nodes. • Patients with lymph nodes found in the anterior lymphofatty tissue were slightly younger but were otherwise similar with respect to other demographics, prostate-specific antigen, biopsy Gleason score, clinical stage, pathological stage, pathological Gleason score, seminal vesicle invasion, and margin status.
  
  
  CONCLUSIONS
  • Anterior lymphofatty tissue overlying the prostate occasionally contains lymph nodes that can harbour malignant disease and routine excision may eradicate regional tumour burden. • Of patients with nodes, 15% were found to have malignant involvement. • The long-term impact on progression-free and overall survival requires further study.
authors.affiliation: City of Hope National Medical Center, Duarte, CA, USA. byuh@coh.org
authors.forename: Bertram
authors.initials: B
authors.lastname: Yuh
authors.forename: Huiqing
authors.initials: H
authors.lastname: Wu
authors.forename: Nora
authors.initials: N
authors.lastname: Ruel
authors.forename: Timothy
authors.initials: T
authors.lastname: Wilson
mesh_terms: D000273:Adipose Tissue / Q000473:pathology*; D000368:Aged; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology*; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D012371:Robotics