title: [Laparoscopic sentinel lymph node (SLN) dissection for clinically localized prostate carcinoma: results obtained in the first 70 patients].
abstract: OBJECTIVE
  The lymph node metastasis is an important prognostic factor in prostatic cancer. The aim of this prospective study was to evaluate the relevance of the sentinel lymph node biopsy by laparoscopy in staging locoregional patients with clinically localized PC.
  
  
  METHODS
  A transrectal ultrasound-guided injection by 0.3 mL/100 MBq (99m)Tc-sulfur rhenium colloid in each prostatic lobe was performed the day before surgery. The detection was realized intraoperatively with a laparoscopic probe (Clerad(®) Gamma Sup) followed by extensive dissection. Counts of SLN were performed in vivo and confirmed ex vivo. The histological analysis was performed by hematoxyline-phloxine-safran staining and followed by immunochemistry if SLN is free.
  
  
  RESULTS
  Seventy patients with carcinoma of the prostate at intermediate or high risk of lymph node metastases were included. The intraoperative detection rate was 68/70 (97%). Fourteen patients had lymph node metastases, six only in SLN. The false negative rate was 2/14 (14%). The internal iliac region was the first metastatic site (40.9%). A metastatic sentinel node in common iliac region beyond the ureteral junction was present in 18.2%. A non-negligible sentinel metastatic region was the common iliac area (18.2%). Limited or standard lymph node dissection would have ignored respectively 72.7% and 59% of lymph node metastases.
  
  
  CONCLUSIONS
  The laparoscopy is adapted to a broad identification of SLN and targeted dissection of these lymph nodes significantly limited the risk of surgical extended dissection while maintaining the accuracy of the information.
authors.affiliation: Clinique urologique Nantes-Atlantis, avenue J-Cartier, 44800 Saint-Herblain, France. throuss@wanadoo.fr
authors.forename: T
authors.initials: T
authors.lastname: Rousseau
authors.forename: J
authors.initials: J
authors.lastname: Lacoste
authors.forename: A
authors.initials: A
authors.lastname: Pallardy
authors.forename: L
authors.initials: L
authors.lastname: Campion
authors.forename: B
authors.initials: B
authors.lastname: Bridji
authors.forename: A
authors.initials: A
authors.lastname: Mouaden
authors.forename: A
authors.initials: A
authors.lastname: Testard
authors.forename: G
authors.initials: G
authors.lastname: Aillet
authors.forename: G
authors.initials: G
authors.lastname: Le Coguic
authors.forename: E
authors.initials: E
authors.lastname: Potiron
authors.forename: C
authors.initials: C
authors.lastname: Curtet
authors.forename: F
authors.initials: F
authors.lastname: Kraeber-Bodéré
authors.forename: C
authors.initials: C
authors.lastname: Rousseau
mesh_terms: D000368:Aged; D002277:Carcinoma / Q000473:pathology; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000473:pathology*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D021701:Sentinel Lymph Node Biopsy; D013671:Technetium Tc 99m Sulfur Colloid; D018084:Ultrasonography, Interventional
chemical_list: D019275:Radiopharmaceuticals; C512413:nanocis; D013671:Technetium Tc 99m Sulfur Colloid