Most prostate cancer patients found to have lymph node (LN) metastases at the time of radical prostatectomy (RP) are initially managed with observation, researchers reported online ahead of print in the Journal of Urology.

Using the National Cancer Data Base, Piotr Zareba, MD, MPH, and colleagues at Memorial Sloan Kettering Cancer Center in New York identified 7791 men who had LN metastases at the time of RP. Of these, 63% were managed initially with observation, 20% with androgen-deprivation therapy (ADT) alone, 5% with radiotherapy (RT) alone, and 13% with ADT and RT.

Younger age, lower comorbidity burden, and adverse pathologic features were associated with an increased likelihood of receiving combination treatment with ADT and RT. The combination treatment was associated with a significant 31% lower risk of death compared with observation.

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