Fujioka T, Koike H, Aoki H, Ohhori T, Chiba R, Okamoto S
Department of Urology, Iwate Medical University School of Medicine, Morioka, Japan.
Urol Int. 1987;42(5):380-4. doi: 10.1159/000281998.
Staging pelvic lymphadenectomy in 31 cases in stages A2-C prostatic cancer was performed. In 15 of the cases (48%) lymph node invasion was found. Metastatic tendency strengthened with an increase in Gleason scores, although no metastases were found in 38% of the cases with Gleason scores of 8-10. Percutaneous fine-needle aspiration biopsy guided by lymphography was conducted in 14 cases and 17% were false-negative. Lymph node metastases were found in the common iliac lymph nodes in 47%, external iliac lymph nodes in 67% and internal iliac obturator lymph nodes in 100%. Prolonged lymph drainage in 4 cases (13%) and wound infection in 2 cases (3%) were found as postoperative complications, but they were all treated conservatively. So it was concluded that pelvic lymphadenectomy was a reasonable adjunct to total prostatectomy since it provided an accurate assessment of the anatomic distribution of disease, which could be of help in selecting treatment. Dissection of the lymph nodes of the internal iliac obturator was considered quite sufficient to establish the presence of any lymph node metastases.
对31例A2 - C期前列腺癌患者进行了盆腔淋巴结清扫术。其中15例（48%）发现有淋巴结转移。转移倾向随Gleason评分增加而增强，尽管在Gleason评分为8 - 10分的病例中有38%未发现转移。对14例患者进行了淋巴造影引导下的经皮细针穿刺活检，其中17%为假阴性。在髂总淋巴结中发现淋巴结转移的占47%，在髂外淋巴结中占67%，在髂内闭孔淋巴结中占100%。术后并发症包括4例（13%）淋巴引流延长和2例（3%）伤口感染，但均采用保守治疗。因此得出结论，盆腔淋巴结清扫术是全前列腺切除术合理的辅助手段，因为它能准确评估疾病的解剖分布，有助于选择治疗方法。认为对髂内闭孔淋巴结进行清扫足以确定是否存在任何淋巴结转移。
