prostate-report.org

Recommendations of the German S3 guideline related to pelvic lymphadenectomy and radical prostatectomy

Radical prostatectomy is the most frequently used treatment for localized prostate cancer. In a prospective randomized trial radical prostatectomy has been shown to be superior to watchful waiting.

According to the German S3 guideline patients have to be informed about the results of this trial prior to treatment decision. The aims and quality indicators of radical prostatectomy include complete removal of the prostate with negative surgical margins (R0) and preservation of continence as well as potency. According to D’Amico criteria, in low-risk disease pelvic lymph node dissection may be abandoned. If lymphadenectomy is performed a minimum number of ten nodes should be obtained. An extended lymphadenectomy is recommended in locally advanced disease.Radical prostatectomy is a valid treatment option in locally advanced prostate cancer.

For the first time the German S3 guideline determines minimum surgery volumes aimed at quality assurance. Radical prostatectomy has to be performed under the supervision of an experienced surgeon. This includes the number of 50 prostatectomies per year and institution, 25 prostatectomies per surgeon, and an appropriate training program.