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Year : 2018  |  Volume : 29  |  Issue : 6  |  Page : 284-287

Is it worth removing prostatic anterior fat pad to detect lymph node metastasis of prostate cancer during robotic-assisted radical prostatectomy?

1 Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan
2 Department of Urology, Taipei Veterans General Hospital; School of Medicine, National Yang-Ming University; Shu-Tien Urological Research Center, Taipei, Taiwan

Correspondence Address:
Hsiao-Jen Chung
Department of Urology, Taipei Veterans General Hospital, No. 201, Section 2, Shipai Road, Taipei 11217
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/UROS.UROS_73_18

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Objectives: To determine the number of lymph node in prostatic anterior fat pad (PAFP) and the incidence of metastasis in lymph nodes dissected during robotic-assisted radical prostatectomy (RARP). Methods: From May 2011 to November 2015, PAFP were removed in 146 patients who underwent RARP and sent for pathological analysis to determine the number of lymph nodes and incidence of metastasis to the lymph nodes. Another 48 patients without PAFP removal were enrolled as the control group. Operative features including operative time, estimated blood loss, post-operative hospital stay, and the incidence of complications were compared between the two groups. Results: Lymph nodes within PAFP were detected in 14/146 (9.6%) patients, with metastatic lymph nodes in 2/146 (1.3%) patients. The patients with metastatic lymph nodes in the PAFP had no obturator lymph node involvement. There were no significant differences in operative features between the two groups. Conclusions: Our findings demonstrated that PAFP contain lymph nodes, and that the incidence rate of lymph node metastasis was high. There was no increase in the surgical risk when removing PAFP, and therefore we suggest that PAFP be routinely removed during RARP and then analyzed pathologically to allow for precise lymph node staging.

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