title: Does anterior prostatic fat tissue removed during robotic radical prostatectomy contain any lymph nodes?
abstract: BACKGROUND
  We investigated whether anterior periprostatic fat (APPF) tissue removed during robotic radical prostatectomy (RARP) contains any lymph nodes (LNs).
  
  
  METHODS
  APPF tissues removed during RARP in 129 patients were evaluated histopathologically. Correlation with postoperative pathologic stage was made. Patients with a history of previous prostate or bladder surgery and radiation therapy were excluded.
  
  
  RESULTS
  Mean patient age, serum prostate specific antigen (PSA), prostate weight and body mass index (BMI) were 62.2 ±5.5 (range 45-74), 9.3 ±6.3 ng/dl (range 0.26-30.3), 60.3 ±27.2 grams (range 11.0-180) and 26.6 ±1.9 kg/m(2) (range 20.0-30.3), respectively. Overall, LNs in APPF tissues were detected in 14 (10.9%) patients with a mean LN yield of 1.1 ±0.7 LNs (range, 1-3). Among those found, no metastatic LN was detected. Of the patients with pT2a (n = 22), pT2b (n = 15), pT2c (n = 62) and pT3a (n = 21) disease, LNs in APPF tissues were detected in 1 (4.6%), 1 (6.7%), 11 (17.7%) and 1 (4.8%) patient in each group, respectively. Among the patients, LNs in APPF tissues were detected in 0 (0%), 5 (35.7%), 8 (57.1%) and 1 (7.1%) patients of underweight, optimal weight, overweight and obese patients due to body mass index, respectively.
  
  
  CONCLUSIONS
  In our series, LNs were detected in around 10% of the patients. Therefore, this fat should, not be pushed back during RARP but should be removed and sent for pathologic evaluation. Although no metastatic LN was detected in our series, the presence of metastatic LNs might have an impact on the oncologic outcomes of the patients and warrants further research.
authors: Yildirim Beyazit University, School of Medicine, Ankara Ataturk Training and Research Hospital, Department of Urology, Ankara, Turkey.
authors: Ali Fuat
authors: AF
authors: Atmaca
authors: Yildirim Beyazit University, School of Medicine, Ankara Ataturk Training and Research Hospital, Department of Urology, Ankara, Turkey.
authors: Abdullah Erdem
authors: AE
authors: Canda
authors: Ankara Ataturk Training and Research Hospital, Department of Urology, Ankara, Turkey.
authors: Murat
authors: M
authors: Keske
authors: Ankara Ataturk Training and Research Hospital, Department of Urology, Ankara, Turkey.
authors: Muhammed Ersagun
authors: ME
authors: Arslan
authors: Ankara Ataturk Training and Research Hospital, Department of Urology, Ankara, Turkey.
authors: Davut
authors: D
authors: Kamaci
authors: Memorial Sisli Hospital, Department of Urology, Istanbul, Turkey.
authors: Erdal
authors: E
authors: Alkan
authors: Memorial Sisli Hospital, Department of Urology, Istanbul, Turkey.
authors: Mevlana Derya
authors: MD
authors: Balbay
keywords: anterior periprostatic fat tissue; lymph nodes; metastasis; robotic radical prostatectomy