Loeb Stacy, Partin Alan W, Schaeffer Edward M
Brady Urological Institute, Johns Hopkins Medical Institutions Baltimore, MD.
Rev Urol. 2010 Winter;12(1):20-4.
The American Urological Association Best Practice Policy states that although pelvic lymph node dissection (PLND) is commonly done with radical prostatectomy, its morbidity must be considered, particularly in cases in which it offers little additional information. The benefits of PLND include more accurate staging and reassurance for the patient. In addition, PLND may be therapeutic for men with lymph node metastases and may result in long-term biochemical cure for selected node-positive patients. However, the incidence of node positivity is declining, and accordingly a greater number of lymphadenectomies must be performed to benefit 1 patient. In addition to the associated cost, PLND has the potential for morbidity, including lymphoceles, thromboembolic events, ureteral injury, and neurovascular injury. Patients and physicians should therefore assess the risk/benefit ratio associated with PLND on an individual basis to permit informed treatment decisions.
美国泌尿外科学会最佳实践政策指出，尽管盆腔淋巴结清扫术（PLND）通常与根治性前列腺切除术同时进行，但必须考虑其发病率，尤其是在其提供的额外信息很少的情况下。PLND的益处包括更准确的分期以及让患者安心。此外，PLND对有淋巴结转移的男性可能具有治疗作用，并且可能使部分淋巴结阳性患者获得长期生化治愈。然而，淋巴结阳性的发生率正在下降，因此必须进行更多的淋巴结切除术才能使1名患者受益。除了相关成本外，PLND还存在发病风险，包括淋巴囊肿、血栓栓塞事件、输尿管损伤和神经血管损伤。因此，患者和医生应根据个体情况评估与PLND相关的风险/获益比，以便做出明智的治疗决策。
