Pelvic lymphadenectomy for stage B1 adenocarcinoma or the prostate: justified or not?

Of 47 consecutive patients who had undergone staging pelvic lymphadenectomy for clinically localized adenocarcinoma of the prostate 26 had clinical stage B1 disease. Only 2 of these patients (8 per cent) had positive pelvic nodes. The low incidence of lymphatic spread, the potential complications of lymphadenectomy and the role of regional lymphatics in generating an immunological defense raise the question of the efficacy of lymphadenectomy in the treatment of rigidly defined, clinical stage B1 adenocarcinoma of the prostate.