The role of lymphadenectomy in prostate cancer

Abstract

In this review, Fiona Burkhard and colleagues discuss the use of retroperitoneal lymph node dissection in both the staging and treatment of prostate cancer. Their discussion covers the preoperative methods used to assess lymph nodes and compares the merits and drawbacks of extended compared to limited lymphadenectomy when staging prostate cancer, and their possible influence on patient survival. It has been shown that an adequate lymphadenectomy for exact staging of prostate cancer consists of removal of all the tissue along the external iliac vein, in the obturator fossa and along the internal iliac artery. Morbidity associated with this procedure is low, if certain technical details are respected. This review discusses in detail the indications for lymphadenectomy and the extent of dissection, based on the localization of the positive nodes. The potential therapeutic impact of extended lymph node dissection in men with prostate cancer is also addressed.