The impact of PSA on prostate cancer management. Can we abandon routine staging pelvic lymphadenectomy?
Despite a negative metastatic evaluation, up to 100% of patients with high-grade tumors are found to harbor metastatic disease within the pelvic lymph nodes at the time of surgery. This article reviews the literature regarding efforts to refine noninvasive preoperative staging through the use of serum tumor markers, improved radiologic imaging, and histologic analysis of the biopsy specimens. A discussion of the renewed controversy regarding the role of pelvic lymphadenectomy in the management of adenocarcinoma of the prostate follows.
Gingrich
J R
JR
Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA.
Paulson
D F
DF
D000230:Adenocarcinoma / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D000469:Alkaline Phosphatase / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis / Q000097:blood; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*
D014408:Biomarkers, Tumor; D000469:Alkaline Phosphatase; D017430:Prostate-Specific Antigen