Purpose: To determine the incidence of occult lymph node metastases in patients with stage pT3NO prostate cancer. Materials and Methods: Lymph nodes from 95 patients with stage pT3NO prostate cancer were analyzed by immunohistochemistry for extrinsic epithelial cells using epithelial-specific monoclonal antibodies. The extrinsic epithelial cells were also tested for prostate specific antigen expression. Results: Occult lymph node metastases were identified in 15 cases (16 percent) and were more frequent in patients with high primary Gleason grade tumors and seminal vesicle invasion (p = 0.03). In all cases the extrinsic cells were of prostate origin based on prostate specific antigen expression. Conclusions: Occult lymph node metastases can be detected in a substantial proportion of patients with stage pT3NO prostate cancer, are associated with known predictors of disease progression, and may be useful in identifying patients at risk for recurrence and progression.
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