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Detection of occult lymph node metastases in locally advanced node-negative prostate cancer

Nature Clinical Practice Urology volume 4, pages 520–521 (2007)Cite this article

A recent study investigated the significance of occult metastases in the lymph nodes of prostate cancer patients who were originally considered node negative by histological evaluation. In this Viewpoint the authors discuss pelvic lymph node dissection and survival in prostate cancer patients with evidence of lymph node metastases.

Three points of this study are particularly noteworthy. Firstly, the number of lymph nodes removed should be based on findings from cadaveric and human studies, which have demonstrated that 22 lymph nodes represents a pelvic lymph node dissection (PLND).1 More important than the absolute number of nodes, however, is the field from which the nodes derive. Indeed, it seems to be most important to do a meticulous node dissection along the medial and lateral borders of the internal iliac vessels, and not only along the external iliac vessels and obturator fossa. In our series of patients with prostate cancer, approximately two-thirds of all positive resected nodes were located exclusively along the internal iliac vessels or combined with other regions.2

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Authors and Affiliations

  1. NB Dhar is in the Department of Urology, and UE Studer is a Professor in the Department of Urology at the University of Bern, Switzerland.,

    Nivedita B Dhar & Urs E Studer

Authors
  1. Nivedita B Dhar
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  2. Urs E Studer
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Correspondence to Urs E Studer.

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The authors declare no competing financial interests.

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Dhar, N., Studer, U. Detection of occult lymph node metastases in locally advanced node-negative prostate cancer. Nat Rev Urol 4, 520–521 (2007). https://doi.org/10.1038/ncpuro0907

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