The incidence and extent of pelvic lymph node metastases in apparently localized prostatic cancer

Pelvic lymphadenectomy was performed in 300 patients with apparently localized adenocarcinoma of the prostate. Pelvic lymph node metastases were identified in 119 patients (40%) and in 35 of these cases (29%) the metastases involved a solitary lymph node. The incidences of metastases for clinical stage B1, B2 and C tumors were 7, 43, and 60%, respectively. The extent of the metastases in terms of the number and distribution of the involved nodes correlated directly with the clinical stage of the primary tumor. The incidences of metastases associated with well-differentiated, moderately differentiated and poorly differentiated tumors were 27, 45, and 70%, respectively. The degree of tumor differentiation, however, had no apparent impact on the incidence of metastases among patients with clinical stage B1 and C neoplasms. Since tumor stage, tumor grade, and pelvic lymph node metastases have each been demonstrated to be of prognostic significance in prostatic cancer, the status of the pelvic lymph nodes should not be considered an isolated prognostic parameter in patients with otherwise localized prostatic cancer.