Pelvic lymphadenectomy in stage A prostatic cancer

Area of Science:

• Urology
• Oncology
• Surgical Pathology

Background:

• Pelvic lymphadenectomy is a recognized staging procedure for clinically apparent prostatic adenocarcinoma.
• The utility of this procedure for clinically unapparent (incidental) prostate cancer requires further investigation.

Purpose of the Study:

• To evaluate the role of pelvic lymphadenectomy in staging clinically unapparent prostate cancer.
• To determine the incidence of lymph node metastasis in Stage A1 and Stage A2 incidental prostate adenocarcinoma.

Main Methods:

• Retrospective review of 23 cases of clinically unapparent prostate cancer (5 Stage A1, 18 Stage A2) undergoing pelvic lymphadenectomy.
• Analysis of lymph node status following the staging procedure.

Main Results:

• No metastatic disease was found in the pelvic lymph nodes of Stage A1 tumors.
• Metastatic disease was identified in 4 out of 18 Stage A2 tumors.
• Pelvic lymphadenectomy revealed unexpected metastatic disease in a subset of Stage A2 incidental prostate cancer cases.

Conclusions:

• Pelvic lymphadenectomy is a useful staging modality in selected cases of incidental adenocarcinoma of the prostate.
• The procedure is particularly indicated for Stage A2 incidental prostate cancer to detect potential lymph node involvement.