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Comparative effectiveness of minimally invasive versus open lymphadenectomy in urological cancers.
MedLine Citation:
PMID:  23202287     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: With increasing adoption of minimally invasive surgical techniques in urologic oncology, the efficacy, safety, and adequacy of lymphadenectomy were reviewed for studies about prostate, bladder, kidney, upper tract urothelial, testicular, and penile cancer published in the past 18 months.
RECENT FINDINGS: In prostate cancer, in which robotic prostatectomy has become the predominant approach, use of extended lymphadenectomy has increased with lymph node yield nearing 20. Minimally invasive lymphadenectomy in bladder cancer does not yet approach the yield seen at high-volume open cystectomy centers, but a larger proportion of robotic lymph node dissections surpass the oncologic threshold of 10-14 lymph nodes compared with open surgery. Comparative lymphadenectomy data for kidney and upper tract urothelial cancers remain muddled as routine lymphadenectomy is not performed and both open and laparoscopic/robotic nephroureterectomy carry no consensus on templates. Minimally invasive retroperitoneal lymph node dissection carries safety and oncologic equivalence to the open technique only in limited centers, whereas minimally invasive ilioinguinal lymphadenectomy for penile cancer remains exploratory at this time.
SUMMARY: Findings from the prior year suggest that - in high-volume centers - lymph node dissection for urologic cancers is equivalent between open and minimally invasive techniques in lymph node yield and short-term to medium-term oncologic results.
Authors:
Sandip M Prasad; Arieh L Shalhav
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current opinion in urology     Volume:  23     ISSN:  1473-6586     ISO Abbreviation:  Curr Opin Urol     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9200621     Medline TA:  Curr Opin Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  57-64     Citation Subset:  IM    
Affiliation:
aDepartment of Urology, Medical University of South Carolina, Charleston, South Carolina bSection of Urology, University of Chicago Hospitals, Chicago, Illinois, USA.
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