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TheScientificWorldJOURNAL
Volume 7, Pages 789-799
http://dx.doi.org/10.1100/tsw.2007.148
Review Article

The Role of Pelvic Lymphadenectomy in the Management of Prostate and Bladder Cancer

1Department of Urology, Tulane University Health Sciences Center, 1430 Tulane Avenue, SL-42, New Orleans, LA 70112, USA
2Department of Urology, Loyola University Stritch School of Medicine, 2160 South First Avenue, Building 54, Room 261, Maywood, IL 60153, USA

Received 23 October 2006; Revised 30 January 2007; Accepted 9 February 2007

Academic Editor: Robert Flanigan

Copyright © 2007 Michael E. Woods et al.

Abstract

A pelvic lymph node dissection is commonly performed by urologists in the surgical management of prostate and bladder cancer. Identification of lymph node metastases provides important prognostic information for both diseases. Despite advances in radiographic imaging, a pelvic lymphadenectomy remains the most accurate method to stage lymph node involvement. In the past two decades, there has been an increase in the diagnosis of early stage prostate cancer, which has led some to omit a pelvic lymphadenectomy in patients thought to have low probability of positive lymph nodes. There is little debate, however, over the inclusion of a lymph node dissection in bladder cancer given the approximately 25% incidence of unsuspected nodal disease at the time of surgery. Controversy exists over the extent of an appropriate lymphadenectomy and its therapeutic efficacy. This review will examine the need, extent, and the potential prognostic and therapeutic benefits of a pelvic lymphadenectomy in prostate and bladder cancer.