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Update on histopathological evaluation of lymphadenectomy specimens from prostate cancer patients

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Abstract

Background

Metastases to lymph nodes (LNs) represent an unfavorable prognostic factor in patients with prostate cancer (PCa). Histological examination represents the gold standard in the evaluation of the lymphadenectomy (LND) specimens for the presence of secondary deposits.

Methods and results

The metastatic detection rate can vary according to the approach adopted in the microscopic analysis of the LNs, which includes frozen-section examination, total inclusion of the tissue with and without whole-mount sections, serial sectioning, and the application of immunohistochemistry. The assessment of the sentinel LN, the search for micrometastases, and the evaluation of atypical LN metastatic sites further contribute to the detection of the metastatic spread.

Conclusion

In this review, an update on the histopathological evaluation of LND specimens in patients with PCa is given, and focus is made on their clinical and prognostic significance.

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Authors’ contribution

Conti and Santoni wrote the manuscript; Burattini and Scarpelli collected and managed the data; Mazzucchelli and Galosi analyzed the data; Cheng and Lopez-Beltran involved in administrative, technical or material support; Briganti involved in conception and design; Montorsi and Montironi edited the manuscript.

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    Authors and Affiliations

    1. Department of Odontostomatologic and Specialized Clinical Sciences, Section of Urology, Marche Polytechnic University, School of Medicine, via Conca 71, 60126, Ancona, Italy

      Alessandro Conti & Andrea B. Galosi

    2. Medical Oncology, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I, GM Lancisi, G Salesi, via Conca 71, 60126, Ancona, Italy

      Matteo Santoni & Luciano Burattini

    3. Section of Pathological Anatomy, Marche Polytechnic University, School of Medicine, AOU Ospedali Riuniti, via Conca 71, 60126, Torrette, Ancona, Italy

      Marina Scarpelli, Roberta Mazzucchelli & Rodolfo Montironi

    4. Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA

      Liang Cheng

    5. Department of Surgery, Cordoba University Medical School, Cordoba, Spain

      Antonio Lopez-Beltran

    6. Unit of Urology/Division of Oncology, URI, IRCCS Ospedale San Raffaele, Milan, Italy

      Alberto Briganti & Francesco Montorsi

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    1. Alessandro Conti
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    Alessandro Conti and Matteo Santoni have contributed equally to this work.

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    Conti, A., Santoni, M., Burattini, L. et al. Update on histopathological evaluation of lymphadenectomy specimens from prostate cancer patients. World J Urol 35, 517–526 (2017). https://doi.org/10.1007/s00345-015-1752-8

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