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238
https://t.me/med1917
H.G. van der Poel et al.
Percentage
of SLN
outside of
extended
LND
plate (%
patients) Complications
Percentage
of SLN
outside of
limited
LND
plate (%
patients)
Percentage
of false
negative
lymph
node (%)
Percentage
of positive
lymph
node (%
patients)
Percentage
of SLN
detection
Excised
SLN
(n)
Patient features
Numb er
Primary
(D’Amico risk
SLN dissection
of
(median)
treatment
classi cation)
method
patients
Radiotherapy 3.2 (mean) 84 40 NR NR NR NR
risk group
14 Open All risk groups RRP 11 100 14.2 NR 66.2 NR NR
55 Laparoscopic Intermediate-
RARP 2 91 18 NR NR 36 NR
Intermediate-
11 Robot-assisted
NR 98 22.2 1.8 NR NR
RRP (38
patients) and
Intermediate-
groups
54 Open and
and high-risk
laparoscopic
and high-risk
laparoscopic
LRP 22 70.8 7.7 NR 42 20.3 No complication
LRP (16
patients)
groups
26 Laparoscopic Intermediate-
NR 100 40 0 NR 31 NR
Salvage
treatment and
and high-risk
groups
and high-risk
121 Laparoscopic Intermediate-
radiotherapy
groups,
recurrent
prostate cancer
patients
93 Laparoscopic All risk groups LRP 5 92.5 20.4 10.5 79.7 3.6 No complication
Radiotherapy 3 100 33 0 44 19.8 NR
and high-risk
groups,
18 Laparoscopic Intermediate-
Table 15.1 (continued)
Auth ors
133 ]
Vermeeren
et al. [
Inoue et al.
114 ]
Van der Poel
[
98 ]
et al. [
123 ]
Ponholzer
et al. [
109 ]
Jeschke et al.
[
122 ]
Meinhardt
et al. [
115 ]
Rousseau et al.
[
75 ]
De Bonilla-
Damia et al.
[
15 Radioguided Sentinel Lymph Node Biopsy and Lymphatic Mapping in Urogenital Malignancies
https://t.me/med1917
(continued)
lymphoceles,
8 (11 %) limited
lower limb
edema
2(3 %) osteitis
pubis
1(1 %) deep
venous
thrombosis
1 (1 %) transient
obturator nerve
malfunctioning
complication
(%1): bleeding
from ext. iliac
vein
8 minor
complications
(%10):
symptomatic
lymphocele,
pulmonary
embolism and
deep venous
thrombosis
239
RRP 4 96 46 NR 75 13 8 (11 %)
and high-risk
groups
74 Open Intermediate-
89 ]
Joniau et al.
[
RRP 17 98 40 9 NR 28 1 major
Low-risk group RARP 14 100 8 24.4 47.4 10 NR
50 Robot-assisted
Manny et al.
and high-risk
laparoscopic
80 Open Intermediate-
87 ]
124 ]
Stanik et al.
[
[
groups
240
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H.G. van der Poel et al.
rate: %4: 1 ureter
injury,
1 bleeding from
int. iliac vein
NR
Percentage
of SLN
outside of
extended
LND
plate (%
patients) Complications
Percentage
of SLN
outside of
limited
LND
plate (%
patients)
Percentage
of false
negative
lymph
node (%)
Percentage
of positive
lymph
node (%
patients)
outside
seLND)
7 lymphoceles
Percentage
of SLN
detection
Excised
SLN
(n)
(median)
Primary
Patient features
Numb er
(D’Amico risk
SLN dissection
of
treatment
classi cation)
method
patients
1229 Open All risk groups RRP 10 99.8 17.1 2.4 NR NR NR
RRP 6 (median) 96/79 50 24 NR 44 (18 %
66 Open All risk groups RRP 4 (median) 97 9 0 19 3 6 % lymphoceles
74 Open >10 % N+ risk
Partin
nomogram
LRP 5.6 (mean) 96 17.2 8.5 72.1 19.5 Complication
and high-risk
groups
203 Laparoscopic Intermediate-
Table 15.1 (continued)
Auth ors
Winter et al.
119 ]
[
Yuen et al.
135 ]
134 ]
[
Van den Bergh
et al. [
116 ]
Rousseau et al.
[
15 Radioguided Sentinel Lymph Node Biopsy and Lymphatic Mapping in Urogenital Malignancies
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241
suggest that lymph drainage of the kidney may be
rapid and bypass lymph nodes nearby possibly
through direct drainage of the lymph ducts into
the thoracic duct.
15.6 Summary
Radioguided SLN procedures are clinically
established in patients with penile cancer and
increased risk of lymph node metastases. Limited
clinical data is available for radioguided SLN
procedures in prostate and bladder cancer, partially reporting reduced morbidity rates. However,
convincing prospective clinical data is not available yet. For renal and testis cancer, only few
pilot data has been published for radioguided
SLN applications.
Recent improvement in intraoperative detection techniques allowing for better intraoperative
anatomical SLN localization hopefully triggers
prospectively designed randomized clinical trials
investigating the impact of radioguided SLN procedures on outcome and morbidity in prostate,
bladder, testis, and renal cancer.
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