Atmaca Ali Fuat, Canda Abdullah Erdem, Keske Murat, Arslan Muhammed Ersagun, Kamaci Davut, Alkan Erdal, Balbay Mevlana Derya
Yildirim Beyazit University, School of Medicine, Ankara Ataturk Training and Research Hospital, Department of Urology, Ankara, Turkey.
Ankara Ataturk Training and Research Hospital, Department of Urology, Ankara, Turkey.
Cent European J Urol. 2015;68(4):410-4. doi: 10.5173/ceju.2015.650. Epub 2015 Dec 21.
We investigated whether anterior periprostatic fat (APPF) tissue removed during robotic radical prostatectomy (RARP) contains any lymph nodes (LNs).
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.
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.
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.
我们研究了在机器人辅助根治性前列腺切除术（RARP）中切除的前列腺前周围脂肪（APPF）组织中是否含有任何淋巴结（LNs）。
对129例患者在RARP期间切除的APPF组织进行组织病理学评估，并与术后病理分期进行相关性分析。排除有前列腺或膀胱手术史及放疗史的患者。
患者的平均年龄、血清前列腺特异性抗原（PSA）、前列腺重量和体重指数（BMI）分别为62.2±5.5（范围45 - 74岁）、9.3±6.3 ng/dl（范围0.26 - 30.3）、60.3±27.2克（范围11.0 - 180）和26.6±1.9 kg/m²（范围20.0 - 30.3）。总体而言，14例（10.9%）患者的APPF组织中检测到淋巴结，平均淋巴结检出数为1.1±0.7个（范围1 - 3个）。在这些检出的淋巴结中，未检测到转移淋巴结。在pT2a（n = 22）、pT2b（n = 15）、pT2c（n = 62）和pT3a（n = 21）疾病的患者中，每组分别有1例（4.6%）、1例（6.7%）、11例（17.7%）和1例（4.8%）患者的APPF组织中检测到淋巴结。在患者中，根据体重指数，体重过轻、体重正常、超重和肥胖患者的APPF组织中检测到淋巴结的比例分别为0（0%）、5例（35.7%）、8例（57.1%）和1例（7.1%）。
在我们的系列研究中，约10%的患者检测到淋巴结。因此，在RARP期间不应将此脂肪推回，而应切除并送去做病理评估。虽然在我们的系列研究中未检测到转移淋巴结，但转移淋巴结的存在可能会对患者的肿瘤学结局产生影响，值得进一步研究。
