Among 753 autopsy prostatic cancer cases with a metastasis, 476 (63%) had a lymph node metastasis, whereas 277 (37%) did not. Two different lymph node metastatic patterns were observed: Type 1, combined metastasis involving the pelvic and paraaortic lymph nodes; and Type 2, metastasis to the paraaortic lymph nodes, but not to the pelvic lymph nodes. Type 1 metastasis cases showed a significantly more frequent metastasis to the bladder and rectum, and a less frequent metastasis to the lungs and liver. Hydronephrosis occurred more frequently (P < 0.01) in the Type 1. Furthermore, in the Type 1 cases the lymph node metastasis appeared to be continuously invasive, but in the Type 2 cases, metastasis appeared to be the skip type or some metastases may have spread via the vertebral vein bypass route and may have been associated with a hematogenous metastasis. Cancer 65:1843-1846,1990. TTEMPTS TO RECONSTRUCT the pathway Of a me-A tastasis from the autopsy findings have been made, but the interpretation of the findings is difficult because of the complex interrelationships. The authors based their studies on the hypothesis that, even in autopsy cases, those with a smaller number of organs involved in metastasis can be suspected of clinically having been in the early stage of their disease.'-' Quite different results in the frequencies of a metastasis to various organs were seen between cases with a smaller number of metastatic organs involved and those with three or more metastatic organs. Furthermore, some metastasis may have been much more rapidly fatal, and so may have appeared more frequently in the autopsy series. However, cases without metastasis or with only metastasis to one organ may have died from causes other than cancer. Thus, this report mainly presents the results in cases with metastasis confined to one organ with regard to determining the possible mode of a lymph node metastasis of a prostatic cancer by using the same methods as in previous studies.'-' Materials and Methods The mode of metastasis have been studied in 753 autopsy cases of a prostatic cancer with metastasis collected from the Annuals of Pathological Autopsy Cases in Japan, from 1958 through 1980, published by the Japanese Pathological Society.6 Metastasis-free cases and double cancer cases with a prostatic cancer were excluded in the current study. The cases were classified into those with metastasis confined to one organ, those with metastasis to the pelvic and/or paraaortic lymph nodes, and those with metastases of multiple organs, and a comparison was made concerning the frequency of hydronephrosis and that of metastasis to other lymph nodes and to various other organs using the chi-square test. It is not known if the organs were involved in invasion or in metastasis. Therefore, metastasis has been used as a general term throughout this report. Results Among the 753 cases with metastasis, 206 (27%) had metastasis confined to only one organ and 547 (73%) had combined metastases to multiple organs. Among the 206 cases, bone metastasis was...

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