分析攝護腺癌病患之攝護腺前脂肪墊淋巴結侵犯之特徵

翁瑋駿、童敏哲、許兆畬、黃立華、楊晨洸¹、歐宴泉¹

童綜合醫院 外科部 泌尿科；¹台中榮民總醫院 外科部 泌尿科

Analysis of prostate cancer patients with involvement of prostatic anterior fat pad

Wei-Chun Weng, Min-Che Tung, Jow-Yu Sheu, Li-Hua Huang, Chun-Kuang Yang¹, Yen-Chuan Ou¹

Divisions of Urology, Department of Surgery, Tungs' Taichung MetroHarbor Hospital, Taiwan

¹Divisions of Urology, Department of Surgery, Taichung Veterans General Hospital, Taiwan

Purpose:

The presence of lymph nodes within the prostatic anterior fat pad (PAFP) has been noted in several reports. Metastatic cancer can be found in PAFP lymph nodes. The characteristics of patients with PAFP lymph node metastasis are not well described in Taiwanese patients.

Materials and Methods:

From December 2006 to May 2014, 770 consecutive patients received robot-assisted radical prostatectomy(RARP) with PAFP dissection by a single surgeon, Yen-Chuan Ou. Mean age was 65.1 ±7.1 years. PAFP was removed for pathological examination to evaluate the presence of lymphoid tissue and the involvement of prostate cancer.

Results:

Among these 770 patients, 61(7.92%) patients were detected to have 1 to 3 PAFP lymph nodes. 52 patients had one node, 7 patients had two nodes, and 2 patients had three nodes. 6(0.82%) patients had positive metastasis. In these 6 patients, 2 patients had PAFP metastases only and the other 4 patients had concomitant pelvic lymph nodes metastases. The other 55 patients had PAFP nodes but tested negative for malignancy.

Conclusions:

Prostate cancer with metastases to the PAFP nodes has positive correlation with patients who had a high risk of prostate cancer preoperatively. The removal of the PAFP can facilitate the dissection of the prostate apex and bladder neck, and can also result in pathological upstaging if metastasis was present.