title: [Intermediate and high risk prostate cancer patients. Clinical significance of extended lymphadenectomy].
abstract: BACKGROUND
  We examined the quantity and localization of pelvic lymph node (LN) metastases in patients undergoing extended pelvic lymphadenectomy (ePLND).
  
  
  METHODS
  A total of 174 patients with intermediate and high-risk prostate cancer underwent radical prostatectomy (RP) and ePLND. We analyzed the relationship between the number of LNs removed and the number, frequency and topography of LN metastases.
  
  
  RESULTS
  In group 1 (intermediate risk patients, n=115) the average number of LNs removed was 20.5, LN metastases were found in 15 patients (13 %) and the localizations were in the external iliac artery 19 %, the internal iliac artery 32 %, the  obturator foramen 36 %, the common iliac artery 7 %, Marcille's triangle 3 % and sacral regions 3 %. In group 2 (high-risk patients, n=59) the average number of LNs removed was 23.9, LN metastases were found in 19 patients (32 %) and the localizations were the external iliac artery 15 %, the internal iliac artery 26 %, the obturator foramen 19 %, the common iliac artery 29 %, Marcille's triangle 6 % and sacral regions 5 %. The full number of metastases was detected only if more than 15 LNs were removed in group 1 and 18 LNs in group 2.
  
  
  CONCLUSIONS
  At least 15 LNs in the intermediate risk group and at least 18 LNs in high risk group should be removed. The ePLND should include the common iliac artery, the internal iliac artery, Marcille's triangle and sacral regions.
authors.affiliation: Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig Holstein, Campus Kiel, Arnold-Heller-Straße 3, Kiel, Germany. dosmonov@urology.uni-kiel.de
authors.forename: D K
authors.initials: DK
authors.lastname: Osmonov
authors.forename: A
authors.initials: A
authors.lastname: Boller
authors.forename: A
authors.initials: A
authors.lastname: Aksenov
authors.forename: M
authors.initials: M
authors.lastname: Naumann
authors.forename: K P
authors.initials: KP
authors.lastname: Jünemann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D005858:Germany; D019983:Guideline Adherence; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods* / Q000592:standards; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D012307:Risk Factors