Surgical management of node-positive prostate cancer: Perspectives from breast oncology

摘要

The review by Gakis et al. [1] in this issue of European Urology elegantly synthesizes retrospective evidence of the role of pelvic lymph node dissection (PLND) together with radical prostatectomy (RP) among patients with high-risk, clinically node-negative or node-positive prostate cancer (PCa). Although data do not support routine extended PLND (ePLND) for all patients with PCa, evidence points to a disease-free survival benefit, and possibly an overall survival (OS) benefit, as a result of a more complete surgical resection among younger patients with biologically more aggressive and/or advanced disease. The authors also outline the variability in definitions of what ePLND should entail and define the role of more extensive surgery in the context of modern adjuvant systemic therapy and locor-egional radiation.