Pathak Ram A, Hemal Ashok K
Department of Urology, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA.
Transl Androl Urol. 2018 Sep;7(Suppl 4):S498-S504. doi: 10.21037/tau.2018.03.19.
Lymph node dissection (LND) represents a critical step in order to determine lymph node invasion (LNI), not only for prognostic means but also as a therapeutic strategy in the management of patients with prostate cancer (CaP). Indications for performing LND are inconsistent with the American Urologic Association (AUA), European Association of Urology (EAU), and National Comprehensive Cancer Network (NCCN) recommendations differing. A thorough appreciation of lymph node drainage patterns and extent of LND has reshaped our understanding of this disease. Moreover, newer research into this field has directly resulted in refinements to current nomograms with utilization of various prostate-specific antigen (PSA) parameters and genomic medicine. Lastly, the application of newer imaging modalities in combination with molecular-guided robotic surgery has personalized the approach of LND espousing excellent safety, efficacy, and oncologic outcomes in these patients.
淋巴结清扫术（LND）是确定淋巴结侵犯（LNI）的关键步骤，不仅用于预后评估，也是前列腺癌（CaP）患者管理中的一种治疗策略。进行LND的指征与美国泌尿外科学会（AUA）、欧洲泌尿外科学会（EAU）和美国国立综合癌症网络（NCCN）的建议不一致。对淋巴结引流模式和LND范围的深入理解重塑了我们对这种疾病的认识。此外，该领域的最新研究直接导致了利用各种前列腺特异性抗原（PSA）参数和基因组医学对当前列线图进行改进。最后，更新的成像模式与分子引导机器人手术相结合的应用，使LND的方法更加个性化，在这些患者中具有出色的安全性、有效性和肿瘤学结果。
