Is There a Need for Pelvic Lymph Node Dissection in Low Risk Prostate Cancer Patients Prior to Definitive Local Therapy?

In patients with PSA ≤10 ng/ml and biopsy Gleason score ≤6, positive lymph nodes were identified by radio-guided surgery in 6.8% [Wawroschek et al. Urol Int 2003;70:303; Narayan et al. Urology 1994;44:519] (positive biopsies in one lobe) and 10.7% [Wawroschek et al. Urol Int 2003;70:303; Eur Urol 1999;36:595] (positive biopsies in both lobes). Up to 4 positive SLN were found. Therefore, we suggest not to dispense with an operative lymph node staging, even in low risk disease.