Background: The aim of the present study was to evaluate the prevalence and severity of lower limb lymphedema after pelvic lymphadenectomy and radiotherapy to the pelvic lymph nodes in patients with prostate cancer.
Methods: Twenty-six patients underwent combined treatment for high-risk node-positive prostate cancer at Skåne University Hospital between April 2008 and March 2011. The treatment consisted of extended pelvic lymphadenectomy followed by androgen deprivation therapy and radiotherapy. The pelvic lymphnodes, prostate and seminal vesicles were treated with external beam radiotherapy (EBRT) to an absorbed dose of 50 Gy followed by a brachytherapy (BT) boost of 2x10 Gy to the prostate only. Twenty-two patients accepted an invitation to a clinical examination with focus on lower limb swelling. The median time between the end of radiotherapy and examination was 2.2 years (range 1.2-4.1).
Results: Six patients (27%) experienced grade 1 lymphedema and two patients (9%) grade 2 while none had grade 3 or 4 according to the CTC Common Toxicity Criteria scale 4.0. Three patients required treatment with compression stockings.
Conclusion: Brachytherapy and pelvic EBRT have a low incidence of lymphedema (at median 2.2 y after treatment) in patients with high-risk node-positive prostate cancer that have undergone pelvic lymph node dissection.
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http://dx.doi.org/10.1186/1748-717X-8-271 | DOI Listing |
World J Surg Oncol
January 2025
Department of Urology, Peking University Third Hospital, Beijing, China.
Background: Lymphatic leakage is a common complication after radical cystectomy and pelvic lymph node dissection (PLND) for muscle-invasive bladder cancer (MIBC).This study aimed to investigate the risk factors contributing to postoperative lymphatic leakage in patients with MIBC.
Materials And Methods: A total of 534 patients undergoing radical cystectomy and PLND were enrolled in the retrospective study at Peking University Third Hospital from January 2010 to July 2023.
Tech Coloproctol
January 2025
Department of Colorectal Surgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222 Banpodearo, Seochogu, Seoul, 06591, Korea.
Metastatic lateral pelvic lymph node (LPN) in rectal cancer has a significant clinical impact on the prognosis and treatment strategies. But there are still debates regarding prediction of lateral pelvic lymph node metastasis and its oncological impact. This review explores the evidence for predicting lateral pelvic lymph node metastasis and survival in locally advanced rectal cancer.
View Article and Find Full Text PDFTech Coloproctol
January 2025
Department of Colorectal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
Lateral lymph node dissection (LLND) is getting global attention as an a surgical option to reduce local recurrence in locally advanced rectal cancer. As the transanal total mesorectal excision (TaTME) is gaining popularity worldwide, a novel LLND approach was established adopting a two-team approach that combines the transabdominal and transanal approaches using the TaTME technique. This narrative review describes the advantages, anatomical landmarks, surgical techniques, and pitfalls of transanal LLND (TaLLND).
View Article and Find Full Text PDFTech Coloproctol
January 2025
Colorectal Unit, Department of Surgery, Royal Adelaide Hospital, Port Road, SA, 5000, Australia.
Lateral pelvic lymph node dissection (LPLND) for rectal adenocarcinoma is an established treatment modality for selected patients with abnormal lateral pelvic lymph nodes on magnetic resonance imaging (MRI) imaging. The goal of this treatment is to achieve a true R0 resection, including lymphadenectomy, with the aim of improving patient oncological outcome, potentially at the expense of surgical and functional complications. However, there remain several areas of controversy resulting from a distinct lack of clarity regarding effective patient selection, lymph node size criteria, the role and extent of routine neoadjuvant treatment versus surgery alone in selected cases, the impact on patient survival metrics and whether the existing data are even valid in the era of total neoadjuvant therapy (TNT).
View Article and Find Full Text PDFTech Coloproctol
January 2025
Colorectal Division, Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India.
Background: The introduction of total mesorectal excision improved locoregional control for rectal adenocarcinoma significantly. Standardisation of the technique of LPLND is lacking in literature.
Methods: We describe the current practices of case selection and technical details of lateral lymph node dissection in rectal cancer.
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