Patients with prostate cancer (PC) with clinically positive lymph nodes detectable via conventional imaging have always been perceived as a challenge, especially with regard to the value of applying local treatment. Over the years, many of these patients have been treated with androgen deprivation therapy (ADT) only. Studies in this specific setting are scarce and mostly retrospective. This issue of European Urology Oncology contains a systematic review of the role of local treatments in this patient population by Ventimiglia et al. [1]. On the basis of the five papers that they included in the meta-analysis, the authors conclude that local treatment was consistently associated with a benefit in overall survival (OS) and cancer-specific survival (CSS) in cN+ PC patients. Interestingly, however, they recommend performing more randomized control trials (RTCs) designed to answer the question of the value of local treatment for cN+ patients. We do not completely agree with this conclusion and would argue that different questions that are likely to be beneficial for the majority of patients may be more important than the role of local treatment in these patients.
European urology oncology. 2019 May 15 [Epub]
Authors: Silke Gillessen, MD, PhD and Bertrand Tombal, MD, PhD
Division of Cancer Sciences, University of Manchester and The Christie, Manchester, UK; Department of Medical Oncology and Haematology, Cantonal Hospital St.
Gillessen S, Tombal B. Management of Prostate Cancer Patients with Clinically Positive Lymph
Nodes. Eur Urol Oncol (2019), https://doi.org/10.1016/j.euo.2019.04.010