Node Positive Prostate Cancer – Treatment and Survival

Joel T Nowak 

Men diagnosed with node positive (cN1) prostate cancer face many different decisions about their treatments. Among their choices, they need to decide if they want to treat the prostate gland with targeted therapy or just move to systemic therapy.   

Targeted treatment means treating the prostate gland, sometimes called debulking, even though the cancer has already spread outside the gland and moved into the lymph nodes. Urologists disagree that using targeted treatment to the prostate gland will provide an advantage over systemic therapy.  

If targeted treatment is used, it will most likely be some sort of surgery or radiation. A retrospective, observational study was performed to see if either a surgical or radiation type of treatment might be clinically superior compared to the other. The study did not evaluate if there was a clinical advantage to a targeted therapy instead of a systemic treatment.  

The study evaluated the five-year overall mortality (comparing the number of people who died from any cause) and the five-year cancer specific mortality rates (comparing the number of people who died from prostate cancer.  

The study concluded that overall survival and cancer-specific survival for those with node-positive prostate cancer treated with surgery lived longer.  

https://onlinelibrary.wiley.com/doi/10.1002/pros.24317