title: Sentinel lymph node dissection for prostate cancer: experience with more than 1,000 patients.
abstract: OBJECTIVE
  We determined the incidence of positive pelvic lymph nodes in men undergoing radical retropubic prostatectomy and describe the correlation with prostate specific antigen, histological grade and stage. We examined whether tumor cells are localized in the sentinel nodes only or also in other nonsentinel lymph nodes.
  
  
  METHODS
  A total of 1,055 men with prostate cancer underwent radio guided pelvic lymph node dissection and radical retropubic prostatectomy. In men with prostate specific antigen 20 ng/ml or less and biopsy Gleason score 7 or less only sentinel nodes were removed. In men with prostate specific antigen more than 20 ng/ml or Gleason score greater than 7 extended pelvic lymph node dissection was also performed.
  
  
  RESULTS
  Positive lymph nodes were found in 207 men (19.6%). In 63.3% of the men these lymph nodes were detected outside of the region of standard lymphadenectomy. The percent of patients with positive nodes was greater than predicted by currently used nomograms. The higher the preoperative prostate specific antigen, pathological stage and grade, the greater the percent of men with positive sentinel and nonsentinel lymph nodes (p<0.001).
  
  
  CONCLUSIONS
  When deciding on pelvic lymph node dissection, sentinel or extended lymphadenectomy should be performed since more than half of patients have positive nodes outside of the region of standard lymphadenectomy. In cases of positive sentinel nodes extended lymph node dissection should be performed since tumor cells are also detectable in nonsentinel lymph nodes.
authors.affiliation: Department of Urology, Klinikum Augsburg, Augsburg, Germany. dorothea.weckermann@uro.augsburg-med.de
authors.forename: Dorothea
authors.initials: D
authors.lastname: Weckermann
authors.forename: Robert
authors.initials: R
authors.lastname: Dorn
authors.forename: M
authors.initials: M
authors.lastname: Trefz
authors.forename: Theodor
authors.initials: T
authors.lastname: Wagner
authors.forename: Friedhelm
authors.initials: F
authors.lastname: Wawroschek
authors.forename: Rolf
authors.initials: R
authors.lastname: Harzmann
mesh_terms: D000368:Aged; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010388:Pelvis; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood* / Q000473:pathology* / Q000601:surgery; D021701:Sentinel Lymph Node Biopsy
chemical_list: D017430:Prostate-Specific Antigen