Evaluation of complications and biochemical recurrence rates after (super) extended lymph node dissection during radical prostatectomy.

Objective: To evaluate the effectiveness of extended (e-PLND) and super-extended pelvic lymph node dissection (se-PLND) during robot-assisted radical prostatectomy (RARP) by examining lymph node (LN) yield, complications, LN metastasis, and biochemical recurrence (BCR) incidence.

Methods: Between January 2016 and January 2020, 354 consecutive patients with > 5% risk of lymph node involvement (LNI), as predicted by the Memorial Sloan Kettering Cancer Center nomogram, underwent RARP with (s)e-PLND at a high-volume center. The e-PLND involved removing fibrofatty lymphatic tissue around the obturator fossa, internal iliac region, and external iliac vessels.

Extended pelvic lymph node dissection in robot-assisted radical prostatectomy is an independent risk factor for major complications.

The aim of this study is to evaluate the major postoperative complication rate after robot-assisted radical prostatectomy (RARP) and to identify related risk factors. A consecutive series of patients who underwent RARP between September 2016 and May 2021, with or without extended pelvic lymph node dissection (ePLND) were analyzed for postoperative complications that occurred within 30 days following surgery. Potential risk factors related to complications were identified by means of a multivariate logistic analysis.

Confocal laser microscopy for assessment of surgical margins during radical prostatectomy.

Objective: To evaluate the feasibility of confocal laser microscopy (CLM) for intraoperative margin assessment as faster alternative to neurovascular structure-adjacent frozen-section examination (NeuroSAFE) during robot-assisted radical prostatectomy (RARP).

Patients And Methods: Surgical margins were assessed during 50 RARP procedures in patients scheduled for NeuroSAFE. Posterolateral sections were cut and imaged with CLM and further processed to conform with the NeuroSAFE protocol.

Preoperative PSMA-PET/CT as a predictor of biochemical persistence and early recurrence following radical prostatectomy with lymph node dissection.

Background: This study aims to evaluate the predictive value of lymph nodes (LN) suspicious for metastases on preoperative prostate-specific membrane antigen (PSMA) PET/CT for biochemical persistence (BCP) and early biochemical recurrence (BCR) following robotic-assisted radical prostatectomy (RARP) with extended pelvic LN dissection (ePLND).

Methods: We evaluated 213 patients with intermediate and high-risk prostate cancer (PCa) who underwent clinical staging with preoperative Ga- or F-PSMA-PET/CT scan and subsequent RARP with ePLND. Patients were grouped as PSMA- or PSMA+ depending on their LN status on PSMA-PET/CT and subdivided according to histological LN status in pN0 or pN1.

Reassessment of Prostate Biopsy Specimens for Patients Referred for Robot-assisted Radical Prostatectomy Rarely Influences Surgical Planning.

Background: The minimum volume standard is 100 robot-assisted radical prostatectomy (RARP) procedures per hospital in the Netherlands, so patients have to be referred to high-volume surgical centers for RARP. During preoperative work-up, prostate biopsies taken elsewhere are reassessed, with upgrading or downgrading of the initial Gleason grade group a possible consequence.

Objective: To determine if prostate biopsy reassessment leads to adjustment of the surgical plan regarding a nerve-sparing approach and extended pelvic lymph node dissection (ePLND) during RARP.