Studies show that an extended lymph node dissection including the area around the internal and external iliac arteries, as well as the traditional obturator area, may be therapeutic in certain patients having few lymph node metastases. A correlation exists between the number of removed lymph nodes and the time to progression, and certain patients do not have PSA recurrence after 10 years without adjuvant therapy. However, an extensive lymph node dissection causes increased morbidity with lymphocele and lymphedema. Therefore, the benefit of the procedure must outweigh the risk.
At Oslo University Hospital, routine robot-assisted laparoscopic lymph node dissections are performed during the same surgery as the prostatectomy. This procedure is rarely performed alone.
- Staging of intermediary and high risk cancer
- To diagnose microscopic tumor spreading
- Possible curative effect if performed with radical prostatectomy