Fluorescence-supported lymphography and extended pelvic lymph node dissection in robot-assisted radical prostatectomy: a prospective, randomized trial

World Journal of Urology
Nina Natascha HarkeJorn H Witt

Abstract

To demonstrate the benefits of fluorescence-supported extended pelvic lymph node dissection (ePLND) compared to regular ePLND in robot-assisted radical prostatectomy. 120 patients with intermediate- or high-risk prostate cancer were prospectively randomized (1:1): in the intervention group, indocyanine green (ICG) was injected transrectally into the prostate before docking of the robot. In both groups, ePLND was performed including additional dissection of fluorescent lymph nodes (LN) in the ICG group. After drop-out of two patients, 59 patients were allocated to the control (A) and intervention group (B) with a median PSA of 8,6 ng/ml. Median console time was 159 (A) vs. 168 (B) min (p = 0.20) with a longer time for ICG-ePLND: 43 (A) vs. 55 min (B) (p = 0.001). 2609 LN were found with significantly more LN after ICG-supported ePLND with a median of 25 vs. 17 LN in A (p < 0.001). Nodal metastases were detected in 6 patients in A (25 cancerous LN) vs. 9 patients in B (62 positive LN) (p = 0.40). In seven of nine patients, ICG-ePLND identified at least one cancer-positive LN (sensitivity 78%), 27 of 62 cancerous LN were fluorescent. Symptomatic lymphocele occurred in one patient in a and in three patients in b (p = 0.62). After a...Continue Reading

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Citations

Jul 8, 2020·International Journal of Urology : Official Journal of the Japanese Urological Association·Masaki ShimboKazunori Hattori
Sep 7, 2018·Clinical & Experimental Metastasis·Ramkishen Narayanan, Timothy G Wilson
Feb 1, 2019·Minerva urologica e nefrologica = The Italian journal of urology and nephrology·Enrico CheccucciFrancesco Porpiglia
Aug 31, 2020·International Journal of Radiation Oncology, Biology, Physics·William A HallColleen A F Lawton
Nov 19, 2020·European Urology·Paolo Dell'OglioMatthias N van Oosterom
Feb 17, 2021·Future Oncology·Timothy RajakumarAlastair D Lamb
Mar 7, 2021·International Journal of Urology : Official Journal of the Japanese Urological Association·Francesco ClapsJose Rubio-Briones
Sep 29, 2019·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Florentien J HinsenveldHenk G van der Poel
Jun 30, 2021·European Journal of Nuclear Medicine and Molecular Imaging·Thomas WendlerMatthias N van Oosterom
Jun 10, 2021·The Quarterly Journal of Nuclear Medicine and Molecular Imaging : Official Publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR), [and] Section of the Society of Radiopharmaceutica·Anne-Claire BerrensUlrich Krafft
Feb 7, 2021·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Elio MazzoneHenk van der Poel

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