Topography and Lateralization of Nodal Metastases in Muscle-Invasive Bladder Cancer Using Super-Extended Pelvic Lymph Node Dissection with the Sentinel Lymph Node Technique
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients and Study Design
2.2. Study Outcomes
2.3. Radiocolloid Injection and SPECT-CT Imaging
2.4. Definitions of Lymphadenectomy Ranges
2.5. Surgical Procedure
2.6. Histopathological Evaluation
2.7. Statistical Analysis
3. Results
3.1. Patients Characteristics
3.2. Topography of SLNs
3.3. Topography of Nodal Metastases
3.4. Lateralization of Nodal Metastases
3.5. Lymphadenectomy Templates
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Region (Color in the Figure 1) | Anatomical Boarders |
---|---|
Obturator fossa region (red) | Bifurcation of internal and external iliac arteries, medial border of external iliac artery, pelvic floor, and obturator nerve |
External iliac region (blue) | Bifurcation of internal and external iliac arteries, endopelvic fascia, psoas muscle, and medial border of external iliac artery |
Internal iliac region (yellow) | Bifurcation of internal and external iliac arteries, bladder wall, obturator nerve, and pelvic floor |
Common iliac region (green) | Medial boarder of common iliac artery, psoas muscle, bifurcation of internal and external iliac arteries, and aortic bifurcation |
Presacral region (purple) | Medial borders of common iliac arteries and promontory and proximal sacrum to the level of bifurcation of internal and external iliac arteries |
Marcille’s fossa region (grey) | The fifth lumbar vertebra medially, the inner edge of the muscle large psoas laterally, the upper edge of the wing of the sacrum below |
SPECT-CT | Gamma Probe | |
---|---|---|
Mean ± SD | 3.6 ± 2.0 | 3.6 ± 1.9 |
Median (Q1, Q3) | 3 (2, 4) | 3 (2, 4) |
Min; Max | 0; 9 | 0; 9 |
LND Template | LN+ Patients with Correct Staging, n/Total (%) | LN+ Patients with All Positive LNs Removed, n/Total (%) | Number of Positive LNs Removed, n/Total (%) | Number of LNs Removed, n/Total (%) |
---|---|---|---|---|
lPLND | 11/22 (50.0) | 5/22 (22.7) | 27/72 (37.5) | 435/1414 (30.8) |
lPLND + SLND | 14/22 (63.6) | 10/22 (45.5) | 38/72 (52.8) | 573/1414 (40.5) |
sPLND | 17/22 (77.3) | 9/22 (40.9) | 44/72 (61.1) | 776/1414 (54.9) |
sPLND + SLND | 21/22 (95.5) | 15/22 (68.2) | 53/72 (73.6) | 848/1414 (60.0) |
ePLND | 19/22 (86.4) | 12/22 (54.5) | 57/72 (79.2) | 946/1414 (66.9) |
ePLND + SLND | 22/22 (100) | 17/22 (77.3) | 63/72 (87.5) | 1012/1414 (71.6) |
mePLND | 19/22 (86.4) | 13/22 (59.1) | 61/72 (84.7) | 1132/1414 (80.1) |
mePLND + SLND | 22/22 (100) | 17/22 (77.3) | 66/72 (91.7) | 1180/1414 (83.5) |
sePLND | 20/22 (90.9) | 19/22 (86.4) | 69/72 (95.8) | 1394/1414 (98.6) |
sePLND + SLND | 22/22 (100) | 22/22 (100) | 72/72 (100) | 1414/1414 (100) |
SLND only | 14/22 (63.6) | 6/22 (27.3) | 24/72 (33.3) | 192/1414 (13.6) |
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Gurwin, A.; Karwacki, J.; Dorochowicz, M.; Kowalczyk, K.; Nowak, Ł.; Jędrzejuk, D.; Krajewski, W.; Hałoń, A.; Bolanowski, M.; Szydełko, T.; et al. Topography and Lateralization of Nodal Metastases in Muscle-Invasive Bladder Cancer Using Super-Extended Pelvic Lymph Node Dissection with the Sentinel Lymph Node Technique. J. Clin. Med. 2024, 13, 5127. https://doi.org/10.3390/jcm13175127
Gurwin A, Karwacki J, Dorochowicz M, Kowalczyk K, Nowak Ł, Jędrzejuk D, Krajewski W, Hałoń A, Bolanowski M, Szydełko T, et al. Topography and Lateralization of Nodal Metastases in Muscle-Invasive Bladder Cancer Using Super-Extended Pelvic Lymph Node Dissection with the Sentinel Lymph Node Technique. Journal of Clinical Medicine. 2024; 13(17):5127. https://doi.org/10.3390/jcm13175127
Chicago/Turabian StyleGurwin, Adam, Jakub Karwacki, Mateusz Dorochowicz, Kamil Kowalczyk, Łukasz Nowak, Diana Jędrzejuk, Wojciech Krajewski, Agnieszka Hałoń, Marek Bolanowski, Tomasz Szydełko, and et al. 2024. "Topography and Lateralization of Nodal Metastases in Muscle-Invasive Bladder Cancer Using Super-Extended Pelvic Lymph Node Dissection with the Sentinel Lymph Node Technique" Journal of Clinical Medicine 13, no. 17: 5127. https://doi.org/10.3390/jcm13175127