Clinicopathologic features of unsuspected regional lymph node metastases in prostatic adenocarcinoma

Histologic features of the primary tumor and their effects on the incidence of unsuspected pelvic lymph node metastases have been studied in a prospective series of 62 patients with clinical stage B1, B2, or C prostatic adenocarcinoma who underwent pelvic lymph node removal. Twenty-one patients (34%) proved to have unsuspected nodal metastases. Differentiation of the primary tumor and extent of involvement of the prostate by carcinoma were the only two features that correlated significantly with the incidence of pelvic nodal metastases, 56% of those with undifferentiated tumors had metastases. Thirty-one of these patients underwent total prostatectomy; an average of only 46% of the sections of prostate contained tumor in the patients without metastases but an average of 65% of the sections were involved by carcinoma in those patients who did have nodal metastases.