[What is the value of radical prostatectomy in lymph node positive prostate carcinoma?]

Improved diagnostic procedures prior to radical prostatectomy have led to a reduced rate of positive lymphnodes in patients with clinical stage T1-T2 prostate cancer. According to current datas prolongation of survival following radical prostatectomy alone in patients with positive lymphnodes is not certain. Whether the recurrence free interval is prolonged is not known due to the lack of prospective randomized trials. Since it is not possible to define the small group of patients who will develop pronounced local symptoms after radical prostatectomy has been abandoned because of positive lymphnodes, radical prostatectomy cannot be recommended in general. In summary there is rarely an indication for radical prostatectomy in patients with stage T1-T2 prostate cancer and pelvic lymphnode metastasis.