Salvage lymph node dissection in recurrent prostate cancer patients.

摘要

The advent of the sentinel node concept as well as new functional imaging modalities improved our knowledge of the anatomy of lymphatic drainage of the prostate. It became clear that lymph node metastasis in prostate cancer (PCa) follows a certain centripetal pattern that starts in the periprostatic area; proceeds in the pelvis by the obturator, intern iliac, extern iliac, pararectal, and presacral nodes; continues to the extern iliac, retroperitoneal, and mediasti-nal nodes; and eventually goes into the thoracic duct, opening into the venous system [1 ]. Most authors currently consider limited lymphadenectomy as a standard addition to radical prostatectomy (RP), mostly for staging purposes; however, in a small subset of patients, its anatomic extent might improve long-term prognosis [2].