Sentinellymphknotendiagnostik beim lokoregionären Prostatakarzinom

PURPOSE: We determined the incidence of positive pelvic lymph nodes
in men undergoing radical retropubic prostatectomy and describe the
correlation with prostate specific antigen, histological grade and
stage. We examined whether tumor cells are localized in the
sentinel nodes only or also in other nonsentinel lymph nodes.
MATERIALS AND METHODS: A total of 1,055 men with prostate cancer
underwent radio guided pelvic lymph node dissection and radical
retropubic prostatectomy. In men with prostate specific antigen 20
ng/ml or less and biopsy Gleason score 7 or less only sentinel
nodes were removed. In men with prostate specific antigen more than
20 ng/ml or Gleason score greater than 7 extended pelvic lymph node
dissection was also performed. RESULTS: Positive lymph nodes were
found in 207 men (19.6%). In 63.3% of the men these lymph nodes
were detected outside of the region of standard lymphadenectomy.
The percent of patients with positive nodes was greater than
predicted by currently used nomograms. The higher the preoperative
prostate specific antigen, pathological stage and grade, the
greater the percent of men with positive sentinel and nonsentinel
lymph nodes (p