Original contributionTotal submission of lymphadenectomy tissues removed during radical prostatectomy for prostate cancer: possible clinical significance of large-format histology☆,☆☆,★
Introduction
The recent article by Perry-Keene et al [1] entitled “Total submission of pelvic lymphadenectomy tissues removed during radical prostatectomy for prostate cancer increases lymph node yield and detection of micrometastases” examined 109 pelvic lymphadenectomies accompanying radical prostatectomy specimens to assess the benefit of complete submission of the lymph node packets, processed with standard histologic cassettes, to detect extra lymph nodes and metastatic disease. They found that submission of all pelvic lymphadenectomy tissue for histologic examination improves the yield of lymph nodes and the detection of metastatic prostate cancer.
The aim of this study is to report our experience on the whole-mount technique (ie, large-format histology) for the histologic examination of all pelvic lymphadenectomy tissue.
Section snippets
Materials and methods
We adopted the whole-mount technique for the histologic examination of all pelvic lymphadenectomy tissue. This was done in 9 cases (group 1) received from 1 of 5 urology services whose radical prostatectomy specimens, including their pelvic lymphadenectomy tissue, were examined by one of us and the main findings shared and discussed with the others of our groups. The main scope was to identify the pros and cons of the whole-mount technique for the complete histologic sampling of lymphadenectomy
Results
The characteristics of the specimens containing lymph nodes in the 3 groups are reported in the Table.
When complete sampling with the whole-mount technique was adopted (group 1) (Fig. 1), the median number of blocks/slides per case was 3 (range, 2-4), the number of blocks/slides being 6 and 1.7 times greater when complete sampling was done with standard cassettes (median and range, 18 [10-24]) (group 2) and when sampling with standard cassettes involved only palpable lymph nodes (median and
Discussion
We have previously reported the clinical advantages and disadvantages of the whole-mount technique applied to the examination of the prostate gland, its base, and the seminal vesicles. In the previous reports, we concluded that we were in favor of complete sampling of the prostatectomy specimens with cancer with the whole-mount technique, with a few drawbacks [3], [4]. The feasibility of doing IHC on whole-mount sections was previously reported by our group when dealing with radical
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The pathway of isolated seminal vesicle invasion has a different impact on biochemical recurrence after radical prostatectomy and pelvic lymphadenectomy
2023, Urologic Oncology: Seminars and Original InvestigationsThe Hunt for Lymph Nodes: Is Total Submission of Standard-Template and Extended-Template Pelvic Lymph Node Dissections Necessary for Detecting Metastatic Prostate Cancer?
2023, Archives of Pathology and Laboratory MedicineHistological Evaluations of RADICAL Prostatectomy Specimens
2022, Robotic Urologic Surgery: Third Edition
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Competing interests: The authors have no conflict of interest to declare.
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This report was supported by grants from the Polytechnic University of the Marche Region, Ancona, Italy (M. S., R. Ma., and R. M.).
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The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the Polytechnic University of the Marche Region (Ancona, Italy).
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Contributed equally to this work.