Histological Assessment of Lymph Node Metastases in Staging Lymphadenectomy for Prostate Cancer

Pelvic lymph node involvement in 44 patients with histologically confirmed prostatic carcinoma was assessed by open lymphadenectomy (24 patients) or laparoscopic lymph node dissection (20 patients). With open lymphadenectomy, node metastases were diagnosed on frozen section prior to radical surgery, in only 2 out of 7 patients. With laparoscopic dissection, metastases were correctly diagnosed in 6 out of 7 patients; one, however, was missed. Reasons for missing node metastases lie in the difficulty of recognizing nodes harboring carcinoma on gross examination. Indeed, metastases are often small and do not significantly alter the macroscopic appearence of the involved lymph node.