Kevin Zorn

Followers

Following

Co-authors

Public Views

Interests

Uploads

Papers by Kevin Zorn

1642 Pelvic Lymph Node Dissection is Performed Less Frequently in Patients Treated with Minimally Invasive Radical Prostatectomy

The Journal of Urology, Apr 1, 2011

operative VTE in two groups of patients operated on by two surgeons; one who consistently used he... more operative VTE in two groups of patients operated on by two surgeons; one who consistently used heparin with SCDs (Group 1) and the other who used SCDs alone (Group 2) for prophylaxis. METHODS: An IRB approved prospectively managed database was analyzed. Group 1 received SCDs just prior to induction and 5,000 units of heparin subcutaneously just after induction. SCDs continued postoperatively and heparin was given twice a day until discharge. Group 2 maintained SCDs until ambulatory. VTE rate, patient age, BMI, operative time, lymphocele rate, estimated blood loss, and pathologic stage were compared between the two groups. Categorical variables were analyzed with chi square test of proportions and continuous variables with t-test using SPSS v 14 software. RESULTS: 1,035 consecutive patients underwent robotic prostatectomy between August 1, 2007 and September 30, 2010. 652 patients received heparin/SCDs and 383 received SCDs alone. Patient age, BMI, estimated blood loss, and pathologic stage were the same in the two groups. There was one lymphocele in each group. Although operative times were longer in Group 2 (228.0 v 165.4 min, p 0.001), the incidence of VTE was the same (0.8% v 0.8%, p .620). BMI, operative time, EBL, and the performance of lymph node dissection were not associated with VTE. CONCLUSIONS: The risk of VTE in patients undergoing robotic prostatectomy is low and not significantly reduced with the administration of prophylactic heparin/SCDs compared to SCDs alone.

569 Pelvic Lymph Node Dissection (PLND) is Performed Less Frequently in Patients Treated with Minimally Invasive Radical Prostatectomy (Mirp)

European Urology Supplements, Mar 1, 2011

nodes as well as of nodal metastases according to landing zone (namely, obturator, external iliac... more nodes as well as of nodal metastases according to landing zone (namely, obturator, external iliac and hypogastric nodes +/-common iliac nodes). Kaplan-Meier curves assessed CSS rates according to the number of positive landing zone (1 vs ≥2), as well as to the laterality of positive nodes (mono vs bilateral). Multivariable Cox regression models tested the association between number of positive landing sites as well as laterality and CSS after accounting for PSA, number of positive nodes, number of nodes removed, pathological Gleason, and stage. results: Mean age was 65.3 years (median: 65.4; range: 44-83). Mean PSA was 39.4 ng/ml (median 14; range 0.9-350 ng/ml). Overall, the mean number of nodes removed was 20.5 (median:19; range: 5-63) while the mean number of positive nodes was 5.5 (median: 3; range:2-59). Mean follow-up was 55.3 months (median 45; range 6-199). Overall, 102 (27.4%) pts had 1 single positive landing sites, while the remaining 270 (72.6%) had >1. Of all pts, 242 (65.1%) had bilateral nodal invasion. Prostate CSS rates at 5 and 10 years were 86 and 73%. At Kaplan Meier analysis, no differences in CSS were found between pts with 1 vs >1 positive landing sites at 5 and 10 year follow-up (87 and 75% vs 81 and 73%;p=0.3). Similarly, no differences were found when laterality was considered (p=0.76). These results were confirmed at multivariable analyses where number of positive landing sites and laterality did not show any association with CSS (all p≥0.3). Conversely, number of positive nodes represented the only independent predictor of CSS (all p ≤0.008). Conclusions: This is the first study investigating the impact of number as well as the laterality of positive landing sites on CSS in patients with node positive prostate cancer. We demonstrated that number of positive nodes, regardless their location, represent the only pathological variable associated with survival in this patient category.

Kevin Zorn

Uploads

Papers by Kevin Zorn

Log In