Assessment of the regional lymph node status in radiation monotherapy of prostatic cancer

A total of 181 prostatic cancer patients under radiation monotherapy was tested for the therapeutic effect of pelvic lymphadenectomy (PLA). Sixty-seven belonging to the pN0 category formed a highly selective group and presented an 89% rate of 7-year survival. Localized radiation therapy with pelvic irradiation (81 patients) upon conventional exclusion of lymphogenic macro metastases, in probable presence of micrometastases, produced equally good results. Extended pelvic irradiation in cases of conventionally verified regional lymphogenic macrometastases remained without therapeutic effect. The combination of PLA with pelvic irradiation, when regional metastases have already occurred (23 patients), may be fit for localizing the tumour process, since the survival rates, compared to those of the pN0 group, showed no significant difference. For that reason, furthermore for the difficulty to determine the N category accurately by conventional methods, it is recommended to perform PLA prior to radiation monotherapy.