Sense and nonsense of an extended pelvic lymph node dissection in prostate cancer

Anthony Van Baelen, Nicolas Mottet, Martin Spahn, Alberto Briganti, Paolo Gontero, Steven Joniau

Research output: Contribution to journalArticle

Abstract

Lymph node metastases associated with prostate cancer (PCa) has been shown to be a poor prognostic factor. The role of pelvic lymph node dissection (PLND) itself in relation to survival remains unclear, however. A Medline search was conducted to address this issue. The following conclusions were drawn. Only recently, improved survival due to completion of radical prostatectomy (RP) (compared to abandoning RP) in known or presumed lymph-node-positive patients has been shown. Lymph node sampling can only be considered representative if an adequate number of nodes is removed. While several authors have suggested that a therapeutic benefit in patients undergoing RP is not provided by PLND, the reliability of these studies is uncertain. Contrary to this, several studies have indicated the possibility of long-term survival even in the presence of limited lymph node metastases. The role and timing of initiation of adjuvant androgen deprivation therapy (ADT) in patients who have node-positive disease after RP is controversial. Recent studies suggest that delaying ADT may not adversely impact survival.

Original languageEnglish
Article number983058
JournalAdvances in Urology
DOIs
Publication statusPublished - 2012

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Urology

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