Radical excision of adenocarcinoma of prostate with pelvic lymph node involvement: surgical gesture or curative procedure

From 1967 to 1981, 100 patients with carcinoma of the prostate and positive lymph node involvement underwent pelvic lymphadenectomy and radical retropubic prostatectomy. At surgery, adjuvant treatment consisted of none in 52, orchiectomy in 37, and other (radiation and/or diethylstilbestrol) in 11 subjects. Of all the variables assessed (tumor bulk, grade, seminal vesicle involvement, number of positive nodes, and adjuvant treatment), only the number of positive nodes was found to affect survival and progression when no adjuvant treatment was given. Progression was significantly limited by orchiectomy, which had an equalizing effect on all patients with positive nodes, possibly independent of the number of positive nodes.