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Whither pelvic lymphadenectomy in prostatic cancer?
Author(s) -
Pollen Jeffrey J.
Publication year - 1982
Publication title -
the prostate
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.295
H-Index - 123
eISSN - 1097-0045
pISSN - 0270-4137
DOI - 10.1002/pros.2990030307
Subject(s) - medicine , cancer , prostate , lymphadenectomy , prostate cancer , prostate disease , urology , gynecology
In the last decade pelvic lymphadenectomy has gained in popularity as a staging maneuver designed to improve the selection of patients with localized prostatic cancer for curative treatment, by uncovering lymph node metastases. The presence of tumor in the regional nodes portends substantial risk for the later appearance of distant metastases. With rare exceptions, lymphadenectomy is widely regarded as a staging procedure without therapeutic benefits. Unfortunately, the operation as routinely performed carries a significant complication rate. The survival results of total prostatectomy for well‐selected nodules of prostatic cancer are excellent without preliminary lymphadenectomy. The morbidity of lymphadenectomy is compounded by superimposed external irradiation. Because of the low complication rate from external radiation alone, it is suggested that patients selected for pelvic radiation be spared the discomfort of lymphadenectomy. Clinical trials of adjuvant chemotherapy in patients with minimal nodal disease may answer the question of whether pelvic lymphadenectomy should ever be performed. It is predicted that noninvasive imaging will improve to the point that staging lymphadenectomy may be relegated to the surgical archives.