Lymph node assessment and lymphadenectomy in prostate cancer

Abstract

The role of lymph node assessment for patients with clinically localized prostate cancer has significantly evolved over the last 20 years. The status of pelvic lymph nodes primarily served as a prognostic marker for prostate cancer. Improved methods in assessing the risk for cancer progression and metastasis have enhanced our ability to identify patients who require pelvic lymphadenectomy during radical prostatectomy. The status of pelvic lymph nodes is also being used to guide further treatments after surgery. Also, recent data has shown possible therapeutic benefit of lymphadenectomy in improving cancer specific survival.

[18F]‐fluorocholine positron‐emission/computed tomography for lymph node staging of patients with prostate cancer: preliminary results of a prospective study

“…The standard procedure is less sensitive, whereas the extended lymphadenectomy has more complications. The debate is ongoing and consensus on standardization or the extent of lymphadenectomy has not yet been reached [3,20].…”

“…The standard procedure is less sensitive, whereas the extended lymphadenectomy has more complications. The debate is ongoing and consensus on standardization or the extent of lymphadenectomy has not yet been reached [3,20]. Standard imaging with CT or MRI appears to be insufficient for lymph node staging of prostate cancer [7,21].…”

Characteristics of Pelvic Lymph Node Metastases in Prostatic Adenocarcinoma

“…Currently, none of the standard imaging techniques, such as computed tomography or magnetic resonance imaging, is able to accurately identify lymph node metastasis as opposed to PLND. 23,24 The sensitivity of computed tomography and conventional magnetic resonance imaging to detect lymph node metastases is only 35%. 23 The specificity of these techniques is about 82%.…”