Indications for laparoscopic pelvic lymph node dissection in the staging of XXXX .

@entity1 @entity263 @entity66 @entity5 @entity1486
Laparoscopic pelvic lymph node dissection is increasing in popularity, in the absence of validated surgical indications. This retrospective study was performed to identify those @entity1 who would benefit from laparoscopic pelvic lymphadenectomy. The case notes of 50 @entity1 who underwent bilateral open pelvic lymphadenectomy with frozen section examination were reviewed. The @entity1 were staged clinically as having A2 (16), B1 (20) and B2 (14) @entity263 . Except for the two @entity1 who had macroscopically involved pelvic lymph nodes at operation, all proceeded to total prostatectomy. Six @entity1 were found to have positive pelvic nodes. Of the six, four @entity1 were clinical stage B2, one was B1 and one was A2. The Gleason score of two of these six @entity1 was greater than seven. The @entity1486 (PSA) levels correlated more with high @entity5 volume (i.e. grade C) rather than with D1 disease. Frozen section at the time of lymphadenectomy had a false negative rate of 2 of 6. We conclude that laparoscopic pelvic lymph node dissections (LPLND) should be performed where there is a high likelihood of @entity66 , @entity5 , poorly differentiated histology and a high PSA reading. We consider that such selective use of LPLND optimizes its diagnostic utility while minimizing its unnecessary application.
