The Role of Lymphadenectomy in Radical Prostatectomy

The accuracy of evaluating lymph node invasion (LNI) in patients with prostate cancer (PC) can still be best achieved through pelvic lymph node dissection (PLND). The occurrence of LNI during radical prostatectomy (RP) with limited PLND (lPLND) is approximately 1-3%. This study presents the frequency of LNI in a cohort of patients with RP who underwent lPLND at our medical institution. Our patients primarily received open retro-pubic RP as a treatment for clinically localized PC. They were categorized into two groups based on whether they underwent PLND or not. We compared the clinical and pathological characteristics of both groups. There were 196 patients who underwent PLND and 149 patients who did not have PLND performed. On average, 4.19 lymph nodes were removed per patient. The incidence of positive nodes was found to be 8.7%. There was no lymphocele formation recorded in study cohort. The rate of positive nodes and the corresponding median number of nodes removed in our study were approximately the same as results reported in literature for lPLND. Although the consensus for extended PLND has been reasonably established, it still remains unclear which template is the most valuable for patients, and oncological benefits seem to be very limited.