From foes to friends: rethinking the role of lymph nodes in prostate cancer.

Clinically localized prostate cancer is often treated with radical prostatectomy combined with pelvic lymph node dissection. Data suggest that lymph node dissection does improve disease staging, but its therapeutic value has often been debated, with few studies showing that lymph node removal directly improves oncological outcomes; however, lymph nodes are an important first site of antigen recognition and immune system activation and the success of many currently used immunological therapies hinges on this dogma. Evidence, particularly in the preclinical setting, has demonstrated that the success of immune checkpoint inhibitors is dampened by the removal of tumour-draining lymph nodes. Thus, whether lymph nodes are truly 'foes' or whether they are actually 'friends' in oncological care is an important idea to discuss.

Nature reviews. Urology. 2024 Aug 02 [Epub ahead of print]

Raghav Gupta, Chandan K Das, Sujit S Nair, Adriana Marcela Pedraza-Bermeo, Ali H Zahalka, Natasha Kyprianou, Nina Bhardwaj, Ashutosh K Tewari

Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Division of Hematology and Medical Oncology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA. .