1987 Volume 78 Issue 1 Pages 18-23
The relationship of tumor grade and local tumor extent to pelvic nodal involvement was assessed surgically in 17 patients who underwent pelvic lymphadenectomy for adenocarcinoma of the prostate.
The relationship of preliminary clinical stage and pelvic lymphnodal metastases was noted in neither of two patients (0%) with stage A, 3 of 9 (33%) with stage B, 5 of 6(83%) with stage C disease.
Of patients with a Mostofi's grade 1, none (0/4) had regional node metastases and all (5/5) had metastasis in the case of grade 3.
Of patients with a Gleason score of 8 or above, all (5/5) had regional nodal metastases, regardless of preliminary clinical stage. Furthermore, no patient with Gleason score of 2, 3 or 4 had nodal metastatic disease (0/3).
In two out of seven cases with pelvic nodal involvement, the grade of metastatic lesion was higher than that of primary lesion.
It is suggested that patients with high grade tumor are included in the group with widespread disease, and patients with low grade tumor are in the group with localized disease. But the ability to predict accurately nodal metastatic disease in patients with moderate grade tumor was variable and argues strongly against staging node dissection in this selected population.
