Małkiewicz Bartosz, Knura Miłosz, Łątkowska Małgorzata, Kobylański Maximilian, Nagi Krystian, Janczak Dawid, Chorbińska Joanna, Krajewski Wojciech, Karwacki Jakub, Szydełko Tomasz
Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology, Wroclaw Medical University, 50-566 Wroclaw, Poland.
Department of Biochemistry, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland.
Cancers (Basel). 2022 May 8;14(9):2326. doi: 10.3390/cancers14092326.
Lymph node invasion in prostate cancer is a significant prognostic factor indicating worse prognosis. While it significantly affects both survival rates and recurrence, proper management remains a controversial and unsolved issue. The thorough evaluation of risk factors associated with nodal involvement, such as lymph node density or extracapsular extension, is crucial to establish the potential expansion of the disease and to substratify patients clinically. There are multiple strategies that may be employed for patients with positive lymph nodes. Nowadays, therapeutic methods are generally based on observation, radiotherapy, and androgen deprivation therapy. However, the current guidelines are incoherent in terms of the most effective management approach. Future management strategies are expected to make use of novel diagnostic tools and therapies, such as photodynamic therapy or diagnostic imaging with prostate-specific membrane antigen. Nevertheless, this heterogeneous group of men remains a great therapeutic concern, and both the clarification of the guidelines and the optimal substratification of patients are required.
前列腺癌中的淋巴结侵犯是一个重要的预后因素，表明预后较差。虽然它对生存率和复发率都有显著影响，但恰当的管理仍然是一个有争议且未解决的问题。对与淋巴结受累相关的风险因素进行全面评估，如淋巴结密度或包膜外侵犯，对于确定疾病的潜在扩展以及在临床上对患者进行分层至关重要。对于淋巴结阳性的患者，可以采用多种策略。如今，治疗方法通常基于观察、放疗和雄激素剥夺治疗。然而，就最有效的管理方法而言，当前的指南并不一致。未来的管理策略有望利用新的诊断工具和疗法，如光动力疗法或使用前列腺特异性膜抗原的诊断成像。尽管如此，这群情况各异的男性仍然是重大治疗难题，既需要明确指南，也需要对患者进行最佳分层。
