Login to Access Video or Poster Abstract: MP97-13
Sources of Funding: none

Introduction

Lymphadenectomy (LND) has become increasingly important in the surgical treatment of prostate cancer amidst an inverse stage migration in patients undergoing robotic assisted laparoscopic prostatectomy (RALP). As such, utilization of extended LND (eLND) during RALP has increased. However, eLND may be associated with increased perioperative morbidity, especially thromboembolic events (VTE) and lymphocele formation. We examined the association of eLND with VTE and lymphocele formation in a contemporary institutional cohort.

Methods

We identified 134 patients in a prospectively maintained institutional database who underwent robotic assisted laparoscopic prostatectomy (RALP) with lymph node dissection (LND) from 1/2014 through 7/2016. Standard (sLND) and extended (eLND) LND were defined as removal of <13 and ?13 lymph nodes, respectively, based on prior literature. Primary endpoints included incidence of VTE and lymphocele within 90 days postoperatively. Logistic regression was used to evaluate the association of clinicopathologic features with VTE._x000D_

Results

A total of 134 patients underwent RALP, including 81 (60.5%) with standard LND (sLND) and 51 (39.6%) with eLND. Median age at surgery was 62 (IQR 57,67), and median follow-up was 283.5 (IQR 103, 496) days. There were no statistically significant differences in baseline clinicopathologic features across eLND and sLND groups. Overall, median lymph node yield was 12 (IQR 8, 16). The overall rate of TEE was 7.5% with a median time to occurrence of 20.5 (IQR 10, 44) days. The rate of TEE was not significantly different between patients who underwent sLND or eLND (6.2% versus 9.4%, p=0.52). On univariable analysis, only longer operative time (OR 1.02, p=0.01) was associated with VTE. The overall rate of lymphocele was 5.3%, with a median time to occurrence of 44 (IQR 10, 63) days. The rate of lymphocele did not differ between patients who underwent sLND or eLND (7.7% versus 3.8%, p=0.44). _x000D_

Conclusions

In this contemporary population of patients undergoing RALP with LND, eLND was not associated with a statistically significant difference in the rate of symptomatic VTE or lymphocele formation when compared to sLND. _x000D_

Funding

none