Prediction of lymphatic metastases by Gleason histologic grading in prostatic cancer

We reviewed retrospectively 90 patients with prostatic cancer to assess Gleason grading as a predictor of pelvic nodal metastases and to compare our results to previous studies. Positive nodes occurred in 0 and 20 per cent of patients with Gleason sums of 2 to 4 and 5 to 6, respectively, which is consistent with previous data. However, nodes were involved in only 44, 60 and 44 per cent of patients with a Gleason sum of 7 to 9, respectively, and nodes were negative in the sole patient with a Gleason sum of 10. These results contrast greatly with previous reports. More experience is required in evaluating the need for staging pelvic lymphadenectomy or treatment in a patient with a given Gleason grade of prostatic cancer.