ABSTRACT
How Common is Lymph Node Involvement in Men with Clinically Localized Prostate Cancer?
Lymph node involvement is more common in patients
with high-to intermediate-risk disease than generally
appreciated. Although commonly quoted nomograms
give estimates of 2% to 38% for such patients, there are
a number of reasons to believe that the true incidence is
substantially underestimated. The pathological findings
from the vast majority of surgical series are based on
prostate patients who underwent at most a standard lymph
node dissection (SLD) for what was thought to be organ
confined disease. Lymph node dissections in many of
these series were either limited to obtrurator lymph
nodes alone or inclusive of external iliac lymph nodes
chains, although the internal lymph nodes are considered
part of the primary lymphatic drainage. In addition, even
the most aggressive node dissection surgeons tend to
ignore presacral and perirectal nodes.
