Pro und Contra der pelvinen Lymphadenektomie beim Prostatakarzinom

Der Stellenwert der pelvinen Lymphadenektomie (LA) als Stagingmaßnahme im Rahmen der radikalen Prostatektomie beim Prostatakarzinom (PCA) wird in der Literatur noch immer kontrovers diskutiert. Während einige Autoren auf der Basis von präoperativen Nomogrammen die pelvine Lymphadenektomie nur bei Patienten mit einem hohen Metastasierungsrisiko befürworten, favorisieren andere aufgrund der fehlenden individuellen Verlässlichkeit der Nomogramme die Lymphadenektomie als generelle operative Maßnahme. Erfolgt die pelvine Lymphadenektomie ist die Frage zu klären, ob diese im Sinne der limitierten oder der extendierten Variante erfolgen sollte.

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