Extended lymphadenectomy for high-risk prostate cancer in patients with chronic lymphocytic leukemia may not be necessary: a report of two cases
Abstract Background Chronic lymphocytic leukemia is a malignancy with good prognosis. However, the incidence of secondary tumors increases every year after the diagnosis of chronic lymphotcytic leukemia. One of the induced secondary tumors is prostate cancer. For high-risk prostate cancer in particu...
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| Format: | Article |
| Language: | English |
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BMC
2019-07-01
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| Series: | BMC Cancer |
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| Online Access: | http://link.springer.com/article/10.1186/s12885-019-5876-x |
| _version_ | 1818326923946754048 |
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| author | Yinjie Zhu Yanqing Wang Zhiyu Qian Jiahua Pan Qiang Liu Baijun Dong Wei Xue |
| author_facet | Yinjie Zhu Yanqing Wang Zhiyu Qian Jiahua Pan Qiang Liu Baijun Dong Wei Xue |
| author_sort | Yinjie Zhu |
| collection | DOAJ |
| description | Abstract Background Chronic lymphocytic leukemia is a malignancy with good prognosis. However, the incidence of secondary tumors increases every year after the diagnosis of chronic lymphotcytic leukemia. One of the induced secondary tumors is prostate cancer. For high-risk prostate cancer in particular, the standard therapy is radical prostatectomy and extended lymphadenectomy, which carries high risks of lymphatic leakage and reduced quality of life. Currently, there has been no study reporting the necessity of extended lymphadenectomy for high-risk prostate cancer in patients with chronic lymphocytic leukemia. Case presentation We reported two cases with concomitant high-risk prostate cancer and chronic lymphocytic leukemia. The first patient was a 60-year-old male diagnosed with synchronous prostate cancer and chronic lymphocytic leukemia. The second patient was a 70-year-old male initially presented with chronic lymphocytic leukemia alone but was then diagnosed with high-risk prostate cancer nine years later. Both patients received neoadjuvant androgen deprivation therapy and robot-assisted radical prostatectomy. The first patient underwent extended lymphadenectomy and developed prolonged postoperative lymphatic cyst. Histology showed chronic lymphocytic leukemia infiltration in resected lymph nodes. Serum prostate-specific antigen levels at one and 13 months post-operation were both 0.01 ng/ml. The second patient received positron emission tomography/computed tomography before androgen deprivation therapy, which showed mild fluorodeoxyglucose-avidity in lymph nodes across the entire body. Lymph node biopsy showed only chronic lymphocytic leukemia. The patient experienced no postoperative complication. Serum prostate-specific antigen levels at one and nine months post-operation were both 0.02 ng/ml. Conclusions Extended lymphadenectomy may not be necessary for patients with concomitant high-risk prostate cancer and chronic lymphocytic leukemia, but such patients must undergo thorough preoperative assessment and mindful postoperative follow-up. Positron emission tomography/computed tomography may be valuable in detecting nodal metastases. A lymph node biopsy is necessary for patients with an ambiguous positron emission tomography/computed tomography in the metastatic involvement of lymph node. |
| first_indexed | 2024-12-13T12:08:06Z |
| format | Article |
| id | doaj.art-3c81dbb9025844339269a70e1d45e9ac |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-13T12:08:06Z |
| publishDate | 2019-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-3c81dbb9025844339269a70e1d45e9ac2022-12-21T23:46:55ZengBMCBMC Cancer1471-24072019-07-011911710.1186/s12885-019-5876-xExtended lymphadenectomy for high-risk prostate cancer in patients with chronic lymphocytic leukemia may not be necessary: a report of two casesYinjie Zhu0Yanqing Wang1Zhiyu Qian2Jiahua Pan3Qiang Liu4Baijun Dong5Wei Xue6Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong UniversityDavid Geffen School of Medicine at University of California Los AngelesDepartment of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Pathology, Renji Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong UniversityAbstract Background Chronic lymphocytic leukemia is a malignancy with good prognosis. However, the incidence of secondary tumors increases every year after the diagnosis of chronic lymphotcytic leukemia. One of the induced secondary tumors is prostate cancer. For high-risk prostate cancer in particular, the standard therapy is radical prostatectomy and extended lymphadenectomy, which carries high risks of lymphatic leakage and reduced quality of life. Currently, there has been no study reporting the necessity of extended lymphadenectomy for high-risk prostate cancer in patients with chronic lymphocytic leukemia. Case presentation We reported two cases with concomitant high-risk prostate cancer and chronic lymphocytic leukemia. The first patient was a 60-year-old male diagnosed with synchronous prostate cancer and chronic lymphocytic leukemia. The second patient was a 70-year-old male initially presented with chronic lymphocytic leukemia alone but was then diagnosed with high-risk prostate cancer nine years later. Both patients received neoadjuvant androgen deprivation therapy and robot-assisted radical prostatectomy. The first patient underwent extended lymphadenectomy and developed prolonged postoperative lymphatic cyst. Histology showed chronic lymphocytic leukemia infiltration in resected lymph nodes. Serum prostate-specific antigen levels at one and 13 months post-operation were both 0.01 ng/ml. The second patient received positron emission tomography/computed tomography before androgen deprivation therapy, which showed mild fluorodeoxyglucose-avidity in lymph nodes across the entire body. Lymph node biopsy showed only chronic lymphocytic leukemia. The patient experienced no postoperative complication. Serum prostate-specific antigen levels at one and nine months post-operation were both 0.02 ng/ml. Conclusions Extended lymphadenectomy may not be necessary for patients with concomitant high-risk prostate cancer and chronic lymphocytic leukemia, but such patients must undergo thorough preoperative assessment and mindful postoperative follow-up. Positron emission tomography/computed tomography may be valuable in detecting nodal metastases. A lymph node biopsy is necessary for patients with an ambiguous positron emission tomography/computed tomography in the metastatic involvement of lymph node.http://link.springer.com/article/10.1186/s12885-019-5876-xProstate neoplasmsChronic lymphocytic leukemiaLymphadenectomyPositron emission tomography/computed tomography |
| spellingShingle | Yinjie Zhu Yanqing Wang Zhiyu Qian Jiahua Pan Qiang Liu Baijun Dong Wei Xue Extended lymphadenectomy for high-risk prostate cancer in patients with chronic lymphocytic leukemia may not be necessary: a report of two cases BMC Cancer Prostate neoplasms Chronic lymphocytic leukemia Lymphadenectomy Positron emission tomography/computed tomography |
| title | Extended lymphadenectomy for high-risk prostate cancer in patients with chronic lymphocytic leukemia may not be necessary: a report of two cases |
| title_full | Extended lymphadenectomy for high-risk prostate cancer in patients with chronic lymphocytic leukemia may not be necessary: a report of two cases |
| title_fullStr | Extended lymphadenectomy for high-risk prostate cancer in patients with chronic lymphocytic leukemia may not be necessary: a report of two cases |
| title_full_unstemmed | Extended lymphadenectomy for high-risk prostate cancer in patients with chronic lymphocytic leukemia may not be necessary: a report of two cases |
| title_short | Extended lymphadenectomy for high-risk prostate cancer in patients with chronic lymphocytic leukemia may not be necessary: a report of two cases |
| title_sort | extended lymphadenectomy for high risk prostate cancer in patients with chronic lymphocytic leukemia may not be necessary a report of two cases |
| topic | Prostate neoplasms Chronic lymphocytic leukemia Lymphadenectomy Positron emission tomography/computed tomography |
| url | http://link.springer.com/article/10.1186/s12885-019-5876-x |
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