ABSTRACT
Patient selection Radical curative surgery is offered to those patients with an expected non-cancer survival of greater than 15 years who demonstrate a high likelihood of organ-confined disease. Those with a biopsy Gleason score of 8 or less, a PSA level below 20 ng/ml and are without palpable bilateral disease are eligible candidates; patients with higher values tend to have more advanced disease and are not eligible for the procedure. Laparoscopic pelvic lymphadenectomy is deemed unnecessary because of the low likelihood of nodal disease if the biopsy Gleason score is less than 7 in the presence of unilateral disease and the serum PSA level is less than 10 ng/ml. When required, the laparoscopic lymphadenectomy is usually carried out immediately prior to prostatectomy.10 While the lymph nodes specimens are processed as frozen sections, the patient is repositioned. RPP is aborted if the lymph nodes are positive for metastatic disease.
