Bilateral Pelvic Lymphadenectomy and Radical Retropubic Prostatectomy for Adenocarcinoma Confined to the Prostate

Abstract

A total of 519 patients with clinical stage B disease underwent radical prostatectomy from 1966-1981; 65 (12.5%) had pathologic stage D1, 72 (14.0%) pathologic stage C and 382 (73.5%) pathologic stage B disease. Of the 519 patients 320 with pathologic stage B1 (239) or B2 (81) adenocarcinoma of the prostate and no prior hormonal or radiation therapy underwent complete pelvic lymphodenectomy and radical retropubic prostatectomy. Stage, grade and size of tumor were associated significantly with interval to disease progression but not with survival. The probable explanation for this observation is that only 2% of 186 patients who were followed for 5 yr and 2% of 46 who were followed for 10 yr died of prostatic carcinoma within these intervals. The over-all survival of patients who had intracapsular prostatic carcinoma was not different from that of an age-matched surgical control group (men undergoing total hip arthroplasty during the same interval). Apparently although morbidity from alternative therapies may very no other treatment modality offers survival superior to that observed for pelvic lymphadenectomy and radical retropubic prostatectomy in patients with pathologic intracapsular prostatic cancer.