title: Sense and nonsense of an extended pelvic lymph node dissection in prostate cancer.
abstract: Lymph node metastases associated with prostate cancer (PCa) has been shown to be a poor prognostic factor. The role of pelvic lymph node dissection (PLND) itself in relation to survival remains unclear, however. A Medline search was conducted to address this issue. The following conclusions were drawn. Only recently, improved survival due to completion of radical prostatectomy (RP) (compared to abandoning RP) in known or presumed lymph-node-positive patients has been shown. Lymph node sampling can only be considered representative if an adequate number of nodes is removed. While several authors have suggested that a therapeutic benefit in patients undergoing RP is not provided by PLND, the reliability of these studies is uncertain. Contrary to this, several studies have indicated the possibility of long-term survival even in the presence of limited lymph node metastases. The role and timing of initiation of adjuvant androgen deprivation therapy (ADT) in patients who have node-positive disease after RP is controversial. Recent studies suggest that delaying ADT may not adversely impact survival.
authors: Department of Urology, University Hospitals Leuven, 3000 Leuven, Belgium.
authors: Anthony
authors: A
authors: Van Baelen
authors: Nicolas
authors: N
authors: Mottet
authors: Martin
authors: M
authors: Spahn
authors: Alberto
authors: A
authors: Briganti
authors: Paolo
authors: P
authors: Gontero
authors: Steven
authors: S
authors: Joniau