Lymphadenectomy for Genitourinary Cancers: Recent Advances and Future Perspectives

Dear Colleagues,

Lymph node dissection has always been and still represents a matter of debate in the urologic community, especially for its oncological staging and therapeutic role. The shift from open to minimally invasive procedures—mainly robotic surgery—improved urologists’ ability to perform more meticulous node dissections with an acceptable rate of complications. Moreover, determining the regional extent of the disease is mandatory in order to guide adjuvant treatments and provide prognostic information for patients, particularly in the current era of immunotherapy. Different controversies still need to be addressed among the scientific community, such as the best template to use as well as the role and extension of salvage lymphadenectomy in prostate cancer patients. Differently, within the last two decades we have witnessed a decline in the use of lymphadenectomy for testicular cancers. The efficacy of the new cisplatin chemotherapy regimen makes it possible to safely perform lymph node dissection only in case of residual disease after chemotherapy. Following this trend, the introduction of sentinel lymph node dissection and the employment of robot-assisted lymphadenectomy in penile cancer reduced the morbidity associated with traditional open surgery. Furthermore, recent advancements in both radiological and nuclear medicine imaging led to a better diagnosis of metastatic spread to lymph nodes. This Special Issue aims to highlight the recent advances, current role, and future perspective of lymphadenectomy in the context of diagnosis, treatment, and prognosis prediction for urologic malignancies.

Dr. Daniele Castellani
Dr. Stefano Puliatti
Dr. Simone Scarcella
Guest Editors

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