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Lymphadenectomy for Genitourinary Cancers: Recent Advances and Future Perspectives
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Lymphadenectomy for Genitourinary Cancers: Recent Advances and Future Perspectives

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nephrology & Urology".

Deadline for manuscript submissions: closed (20 April 2023) | Viewed by 10235

Special Issue Editors

Dr. Daniele Castellani

E-Mail Website
Guest Editor
Urology Unit, Azienda Ospedaliero-Universitaria delle Marche, Università Politecnica delle Marche, 60121 Ancona, Italy
Interests: urologic oncology; minimally invasive surgery; urolithiasis; benign prostate hyperplasia; male fertility
Special Issues, Collections and Topics in MDPI journals
Dr. Stefano Puliatti

E-Mail Website
Guest Editor
1. Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
2. Orsi Academy, Melle, Belgium
Interests: urology; oncology; robotic surgery; minimally invasive surgery; robot-assisted aradical prostatectomy (RARP); robot-assisted partial nephrectomy (RAPN); surgical robotic training
Special Issues, Collections and Topics in MDPI journals
Dr. Simone Scarcella

E-Mail Website
Guest Editor
Department of Urology, Polytechnic University of Marche Region, "Ospedali Riuniti" Hospital, Ancona, Italy
Interests: urology; oncology; robotic surgery; minimally invasive surgery; BPH

Special Issue Information

Dear Colleagues,

Lymph node dissection has always been and still represents a matter of debate in the urologic community, especially for its oncological staging and therapeutic role. The shift from open to minimally invasive procedures—mainly robotic surgery—improved urologists’ ability to perform more meticulous node dissections with an acceptable rate of complications. Moreover, determining the regional extent of the disease is mandatory in order to guide adjuvant treatments and provide prognostic information for patients, particularly in the current era of immunotherapy. Different controversies still need to be addressed among the scientific community, such as the best template to use as well as the role and extension of salvage lymphadenectomy in prostate cancer patients. Differently, within the last two decades we have witnessed a decline in the use of lymphadenectomy for testicular cancers. The efficacy of the new cisplatin chemotherapy regimen makes it possible to safely perform lymph node dissection only in case of residual disease after chemotherapy. Following this trend, the introduction of sentinel lymph node dissection and the employment of robot-assisted lymphadenectomy in penile cancer reduced the morbidity associated with traditional open surgery. Furthermore, recent advancements in both radiological and nuclear medicine imaging led to a better diagnosis of metastatic spread to lymph nodes. This Special Issue aims to highlight the recent advances, current role, and future perspective of lymphadenectomy in the context of diagnosis, treatment, and prognosis prediction for urologic malignancies.

Dr. Daniele Castellani
Dr. Stefano Puliatti
Dr. Simone Scarcella
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • prostate cancer
  • bladder cancer
  • testis cancer
  • penis cancer
  • lymphadenectomy

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Published Papers (3 papers)

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Research

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12 pages, 1460 KiB  
Article
Diagnostic Value of the Sentinel Lymph Node Technique in Patients with Muscle-Invasive Bladder Cancer
by Bartosz Małkiewicz, Diana Jędrzejuk, Adam Gurwin, Karol Wilk, Klaudia Knecht-Gurwin, Paweł Kiełb, Wojciech Krajewski, Marek Bolanowski, Agnieszka Hałoń and Tomasz Szydełko
J. Clin. Med. 2023, 12(9), 3092; https://doi.org/10.3390/jcm12093092 - 24 Apr 2023
Cited by 2 | Viewed by 1852
Abstract
Background: The optimal limits of the bilateral pelvic lymph node dissection (PLND) template in bladder cancer treatment remain controversial. This study aimed to investigate whether radio-guided sentinel node (SLN) detection is a reliable technique for the perioperative localisation of potential lymphatic metastasis during [...] Read more.
Background: The optimal limits of the bilateral pelvic lymph node dissection (PLND) template in bladder cancer treatment remain controversial. This study aimed to investigate whether radio-guided sentinel node (SLN) detection is a reliable technique for the perioperative localisation of potential lymphatic metastasis during cystectomy for muscle-invasive bladder cancer (MIBC). Materials and Methods: We studied 54 patients with pT2-pT4 MIBC who underwent cystectomy with extended PLND (ePLND) augmented by the SLN technique. The identification of SLN was performed by preoperative SPECT/CT hybrid lymphoscintigraphy using peritumoral injection of nanocolloid-Tc-99m, followed by intraoperative navigation with a handheld γ-probe. All nodal specimens were collected separately and then fixed in formalin, stained with haematoxylin and eosin, and examined by an experienced uropathologist. Results: A total of 1414 LNs were resected and examined for the presence of metastases. The mean number of harvested LNs was 26 (range: 11–50) per patient. In 51 of 54 patients, 192 SLNs were resected. In addition, 20/192 (10.4%) SLNs were located outside of the ePLND area. Overall, 72 metastatic LNs (LN+) were found in 22 of 54 patients (40.7%) and in 24/192 SLNs (12.5%). The SLN technique detected LN+ in 14 of 22 (64%) patients. The SLNs were the only sites of metastasis (SLN+ = LN+) in 6 of 22 (27.3%) LN+ patients, including two cases with foci located in the pararectal region. The diagnostic values for the sensitivity, specificity, positive predictive value, and false-negative rate for the SLN technique were 66.66%, 4.16%, 28.57%, and 33.33%, respectively. Extended lymphadenectomy and its combination with the SLN technique enabled the correct assessment in 96.3 and 100% of patients, respectively. Conclusions: The combination of ePLND and SLN provides a better pN assessment compared to ePLND alone. Although the SLN technique has restrictions that limit its diagnostic value, its use as an addition to lymphadenectomy allows for the visualisation of nonstandard lymph drainage pathways that may be potential metastatic routes. Full article
(This article belongs to the Special Issue Lymphadenectomy for Genitourinary Cancers: Recent Advances and Future Perspectives)
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Review

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19 pages, 1700 KiB  
Review
Applications and Safety of Sentinel Lymph Node Biopsy in Endometrial Cancer
by Wan Kam Chiu, Shuk Tak Kwok, Yaokai Wang, Hiu Mei Luk, Aaron Hei Yin Chan and Ka Yu Tse
J. Clin. Med. 2022, 11(21), 6462; https://doi.org/10.3390/jcm11216462 - 31 Oct 2022
Cited by 4 | Viewed by 4876
Abstract
Lymph node status is important in predicting the prognosis and guiding adjuvant treatment in endometrial cancer. However, previous studies showed that systematic lymphadenectomy conferred no therapeutic values in clinically early-stage endometrial cancer but might lead to substantial morbidity and impact on the quality [...] Read more.
Lymph node status is important in predicting the prognosis and guiding adjuvant treatment in endometrial cancer. However, previous studies showed that systematic lymphadenectomy conferred no therapeutic values in clinically early-stage endometrial cancer but might lead to substantial morbidity and impact on the quality of life of the patients. The sentinel lymph node is the first lymph node that tumor cells drain to, and sentinel lymph node biopsy has emerged as an acceptable alternative to full lymphadenectomy in both low-risk and high-risk endometrial cancer. Evidence has demonstrated a high detection rate, sensitivity and negative predictive value of sentinel lymph node biopsy. It can also reduce surgical morbidity and improve the detection of lymph node metastases compared with systematic lymphadenectomy. This review summarizes the current techniques of sentinel lymph node mapping, the applications and oncological outcomes of sentinel lymph node biopsy in low-risk and high-risk endometrial cancer, and the management of isolated tumor cells in sentinel lymph nodes. We also illustrate a revised sentinel lymph node biopsy algorithm and advocate to repeat the tracer injection and explore the presacral and paraaortic areas if sentinel lymph nodes are not found in the hemipelvis. Full article
(This article belongs to the Special Issue Lymphadenectomy for Genitourinary Cancers: Recent Advances and Future Perspectives)
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16 pages, 783 KiB  
Review
Utility of Lymphadenectomy in Prostate Cancer: Where Do We Stand?
by Bartosz Małkiewicz, Paweł Kiełb, Jakub Karwacki, Róża Czerwińska, Paulina Długosz, Artur Lemiński, Łukasz Nowak, Wojciech Krajewski and Tomasz Szydełko
J. Clin. Med. 2022, 11(9), 2343; https://doi.org/10.3390/jcm11092343 - 22 Apr 2022
Cited by 8 | Viewed by 2788
Abstract
The purpose of this review is to summarize the current knowledge on lymph node dissection (LND) in prostate cancer (PCa) patients undergoing radical prostatectomy (RP). Despite a growing body of evidence, the utility and therapeutic and prognostic value of such an approach, as [...] Read more.
The purpose of this review is to summarize the current knowledge on lymph node dissection (LND) in prostate cancer (PCa) patients undergoing radical prostatectomy (RP). Despite a growing body of evidence, the utility and therapeutic and prognostic value of such an approach, as well as the optimal extent of LND, remain unsolved issues. Although LND is the most accurate staging procedure, the direct therapeutic effect is still not evident from the current literature, which limits the possibility of establishing clear recommendations. This indicates the need for further robust and adequately designed high-quality clinical trials. Full article
(This article belongs to the Special Issue Lymphadenectomy for Genitourinary Cancers: Recent Advances and Future Perspectives)
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