Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Patients with Positive Lymph Nodes after Radical Prostatectomy with Pelvic Lymphadenectomy – Do We Know the Proper Way of Management?

Bartosz Małkiewicz
* ORCID logo ,
Miłosz Knura
ORCID logo ,
Małgorzata Łątkowska
,
Maximilian Kobylański
,
Krystian Nagi
,
Dawid Janczak
,
Joanna Chorbińska
,
Wojciech Krajewski
,
Jakub Karwacki
* ,
Tomasz Szydełko
Version 1 : Received: 10 April 2022 / Approved: 11 April 2022 / Online: 11 April 2022 (14:13:34 CEST)

A peer-reviewed article of this Preprint also exists.

Małkiewicz, B.; Knura, M.; Łątkowska, M.; Kobylański, M.; Nagi, K.; Janczak, D.; Chorbińska, J.; Krajewski, W.; Karwacki, J.; Szydełko, T. Patients with Positive Lymph Nodes after Radical Prostatectomy and Pelvic Lymphadenectomy—Do We Know the Proper Way of Management? Cancers 2022, 14, 2326. Małkiewicz, B.; Knura, M.; Łątkowska, M.; Kobylański, M.; Nagi, K.; Janczak, D.; Chorbińska, J.; Krajewski, W.; Karwacki, J.; Szydełko, T. Patients with Positive Lymph Nodes after Radical Prostatectomy and Pelvic Lymphadenectomy—Do We Know the Proper Way of Management? Cancers 2022, 14, 2326.

Abstract

Lymph node invasion in prostate cancer is a significant prognostic factor indicating worse prognosis. While it affects significantly both survival rates and recurrence, proper management remains a heated issue. Thorough evaluation of risk factors associated with nodal involvement, such as lymph node density or extracapsular extension, is crucial to establish potential expansion of the disease and to substratify patients clinically. There are multiple strategies that may be taken into consideration for patients with positive lymph nodes. Nowadays therapeutic methods are generally based on observation, radiotherapy, and androgen deprivation therapy. However current guidelines are incoherent in terms of indication of the most effective management approach. Future management strategies will be expected to reach for novel diagnostic tools and therapies, such as photodynamic therapy or diagnostic imaging with prostate specific membrane antigen. Nevertheless, this heterogeneous group of men remains a vast therapeutic concern, and both clarification of the guidelines and optimal substratification of patients is required.

Keywords

prostate cancer; lymph node invasion; radical prostatectomy

Subject

Medicine and Pharmacology, Urology and Nephrology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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