title: Distribution of lymph nodes in men with prostatic adenocarcinoma and lymphadenopathy at presentation: a retrospective radiological review and implications for prostate and pelvis radiotherapy.
abstract: OBJECTIVE
  To describe the distribution of enlarged lymph nodes by nodal group found radiologically in patients presenting with adenocarcinoma of the prostate. This will help to define which nodal groups should be treated during the pelvic radiotherapy of patients with less advanced disease.
  
  
  METHODS
  The scans of 55 men presenting with prostate cancer and metastases to lymph nodes only were reviewed. Lymph nodes of 8 mm or more in size were considered to be enlarged.
  
  
  RESULTS
  The medial external iliac (obturator) nodes were most commonly enlarged (75% of patients) followed by nodes in the para-aortic region (26%) and anterior internal iliac region (24%). Para-aortic lymph-node enlargement was uncommon in the absence of pelvic lymphadenopathy. Midline pre-sacral lymph-node enlargement was not observed. Incidence of enlarged lymph nodes in the lateral external iliac group was 18%, an area which may not be routinely included during radiotherapy.
  
  
  CONCLUSIONS
  There is a case for studying further the role of including lateral external iliac lymph nodes in the pelvic radiotherapy volume, as there may be an appreciable risk of lymph-node spread to this area.
authors.affiliation: Academic Department of Radiotherapy and Oncology, Royal Marsden Hospital and Institute of Cancer Research, Sutton, UK. andrew.jackson@rmh.nhs.uk
authors.forename: A S N
authors.initials: AS
authors.lastname: Jackson
authors.forename: S A
authors.initials: SA
authors.lastname: Sohaib
authors.forename: J N
authors.initials: JN
authors.lastname: Staffurth
authors.forename: R A
authors.initials: RA
authors.lastname: Huddart
authors.forename: C C
authors.initials: CC
authors.lastname: Parker
authors.forename: A
authors.initials: A
authors.lastname: Horwich
authors.forename: D P
authors.initials: DP
authors.lastname: Dearnaley
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000532:radiotherapy / Q000556:secondary; D000328:Adult; D000368:Aged; D006801:Humans; D015182:Lymphatic Irradiation; D008207:Lymphatic Metastasis / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010388:Pelvis; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000532:radiotherapy; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed