@article{oai:dmu.repo.nii.ac.jp:00005124,
 author = {Yashi, Masahiro and Fuchizawa, Hirotaka and Yokoyama, Megumi and Okazaki, Akihito and Nakamura, Gaku and Kokubun, Hidetoshi and Uematsu, Toshitaka and Suzuki, Issei and Sakamoto, Kazumasa and Tokura, Yuumi and Kijima, Toshiki and Kaji, Yasushi and Ishida, Kazuyuki},
 issue = {1},
 journal = {Dokkyo Medical Journal},
 month = {Mar},
 note = {Background: There are pros and cons regarding the benefit of extended pelvic lymph node dissection (PLND) during surgery for prostate cancer (PCa). A randomized controlled trial failed to demonstrate any survival benefits, and the therapeutic role of PLND remains unclear. We evaluated early survival outcome using a propensity score (PS)-matched analysis.
　Methods: Three hundred ninety-nine patients with intermediate- to high-risk PCa were enrolled. They were determined to have a lymph node (LN) invasion probability of greater than 7% on the established nomogram. The National Comprehensive Cancer Network classification was used as risk stratification. Biochemical recurrence (BCR)-free survival was compared between the two groups divided by the threshold of the LN yield set at 15.
　Results: The mean LN yield was 23.7 and 3.4 in the sufficient (n = 217) and insufficient (n = 182) LN yield groups, respectively. In the unmatched cohort, the advantage of the 3-year BCR-free survival for sufficient LN yield remained at 10.0% (hazard ratio [HR] 0.68, 95% confidence interval [CI] 0.43-1.07; p = 0.098). In the PS-matched cohort with 133 patients in each group, the difference in the 3-year BCR-free survival rate widened to 15.8% (HR 0.54, 95% CI 0.31-0.93; p = 0.027). A Cox regression multivariate analysis performed on the model with postoperative pathological factors showed an independent predictive value of LN yield.
　Conclusions: The results demonstrate the therapeutic role of PLND in intermediate- to high-risk PCa. The benefit of PLND depends on the surgeon adhering to the template and removing a sufficient number of LNs in patients with an optimal risk-range.},
 pages = {39--48},
 title = {Extended Pelvic Lymph Node Dissection during Robotic Prostate Surgery for Intermediate- to High-risk Prostate Cancer: A Propensity Score-matched Analysis for Biochemical Recurrence-free Survival},
 volume = {1},
 year = {2022}
}