The spread of prostate cancer to surrounding tissues will first invade the pelvic lymph nodes, and once lymph node metastasis occurs, the success rate of radiotherapy and radical surgery will be significantly reduced, so the urologist or radiation oncologist will specify whether the pelvic lymph nodes are invaded by the tumor before developing a treatment plan.
- When the risk of lymph node metastasis is low, such as a low Gleason score or PSA less than 10 ng/mL, lymph node dissection is not necessary and the patient can be treated with radiation therapy or radical prostatectomy.
- For high-risk patients with a Gleason score of 8 to 10 or a PSA greater than 10 ng/mL, pelvic lymph node dissection is required in conjunction with radical prostatectomy or before radioactive particle implantation or external irradiation therapy.
So, not every radical prostatectomy needs to be accompanied by pelvic lymph node dissection.
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