The challenge of treating node-positive prostate cancer. An approach to resolving the questions.
BACKGROUND
Prostate cancer commonly presents with positive pelvic lymph nodes. The appropriate management of patients with prostate cancer is controversial and no satisfactory randomized trials have been conducted.


METHODS
Available literature was reviewed, particularly concerning long-term survival after primary surgery or radiation therapy with or without adjuvant androgen deprivation.


RESULTS
With surgery, 10-40% of patients with low volume nodal disease are 10-year, no evidence of disease (NED) survivors and with radiation, 10-20% of node-positive patients are free of failure at 10 years. Few studies include past treatment and prostate specific antigen (PSA) data. It also appears that androgen deprivation may improve survival after surgery.


CONCLUSIONS
At least 40,000 patients of all clinical stages will have node-positive prostate cancer in 1992. A careful systematic investigation by prospective trial of the available treatment options is needed to establish the optimal management of these prostate cancers.
Hanks
G E
GE
Fox Chase Cancer Center/University of Pennsylvania, Philadelphia.
D001918:Brachytherapy; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D009367:Neoplasm Staging; D009919:Orchiectomy; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy / Q000628:therapy*; D015996:Survival Rate
D017430:Prostate-Specific Antigen