The Role of “Marcillectomy” in Extended Pelvic Lymph Node Dissection for High-Risk Prostate Cancer Patients

Abstract

Extended pelvic lymph node dissection (ePLND) is currently the most accurate method for staging prostate cancer (PCa) lymph node (LN) and has been widely adopted, and according to the guidelines of the European Association of Urology, it is recommended for intermediate and high-risk PCa patients. As a landing point for pelvic lymphatic drainage, Marcille's LN is considered an important site for LN metastasis of PCa. By performing histopathologic and molecular analyses, significant lymphatic drainage can be detected in the triangular fossa of Marcille. The Marcille’s lymphadenectomy, called “Marcillectomy”, is able to bring about potential oncology benefits in patients with small-volume lymph node metastases without increasing the rate of complications, which will revolutionize the traditional ePLND approach and recommend the use of Marcillectomy in all high-risk PCa patients.