The therapeutic role of pelvic lymphadenectomy in prostatic cancer

We have reported our observations in 72 patients with clinically localized prostatic cancer who underwent radical transpubic prostatectomy and pelvic lymphadenectomy. Of the 72 patients, histologic examination revealed that 54 had tumor confined within the capsule, three had extracapsular spread of the tumor, and 15 had nodal involvement. It is not clear whether the removal of uninvolved lymph nodes had any benefit, but it is certain that it induced no adverse effect on short-term survival. It seems that pelvic lymphadenectomy can increase the survival of those patients with minimal lymph node metastases (one to two nodes). Three patients with more extensive involvement (three to nine nodes) have survived more than three years without evidence of recurrence. The hope for the cure of prostatic cancer, however, probably lies in the development of more effective anticancer agents that destroy whatever cancer cells are not either excised by radical prostatectomy in combination with pelvic lymphadenectomy or neutralized by irradiation.