本研究旨在研究根治性前列腺切除术（RP）在临床淋巴结转移前列腺癌中的作用，以及通过手术对淋巴结转移进行组织学确认是否有助于治疗。在排除远处转移性前列腺癌或新辅助雄激素剥夺治疗的患者后，我们纳入了在我院接受RP的42例患有临床淋巴结转移的患者进行研究。我们根据是否有病理性淋巴结转移将他们分类。本次回顾性病历分析中分析了他们的临床病理资料。使用Kaplan-Meier分析计算了去势抵抗性前列腺癌（CRPC）无病生存期、生化复发（BCR）无病生存期和肿瘤特异性生存期（CSS）的估计值。 两组之间在年龄、糖尿病、高血压、BCR时间、CRPC时间、总生存率、救治放疗率和初始前列腺特异性抗原水平方面没有显著差异。然而，病理N1组在病理T分期、病理格里森评分、BCR率、CRPC率和CSS方面存在显著差异。我们使用多变量Cox比例风险回归分析来确定CRPC无病生存期的预测因子。病理淋巴结转移患者的CRPC无病生存期较短[风险比（HR）为4.87，95%置信区间（CI）为1.25-19.00，p = 0.02]。 根治性前列腺切除术可以确认淋巴结转移。虽然病理诊断对BCR时间和CRPC时间没有影响，但因为影响BCR率、CRPC率和CSS，通过手术获得准确的病理诊断对于临床淋巴结转移前列腺癌的治疗具有益处。 © 2023. Society of Surgical Oncology.

This study aimed to investigate the role of radical prostatectomy (RP) among clinical nodal metastasis prostate cancer and whether histological confirmation of lymph node metastasis through surgery can help with treatment.After excluding patients with distant metastatic prostate cancer or neoadjuvant androgen deprivation therapy, 42 patients with clinical nodal metastasis who underwent RP at our institution were included in the study. We classified them as having or not having pathological lymph node metastasis. Clinicopathologic data were analyzed in this retrospective chart review. Kaplan-Meier analysis was used to calculate the estimated castration-resistant prostate cancer (CRPC)-free survival, biochemical recurrence (BCR)-free survival, and cancer-specific survival (CSS).There is no significant difference in age, presence of diabetes mellitus, hypertension, BCR time, CRPC time, overall survival, salvage RT rate, and initial prostate-specific antigen level between the two groups. However, there is a significant difference in the pathology N1 group in terms of pathological T stage, pathologic Gleason score, BCR rate, CRPC rate, and CSS. A multivariate Cox proportional hazard regression analysis was used to identify predictors of CRPC-free survival. Patients with pathological lymph node metastasis had a shorter CRPC-free survival [hazard ratio (HR) 4.87; 95% confidence interval (CI) 1.25-19.00, p = 0.02].Radical prostatectomy can confirm lymph node metastasis. Although pathologic diagnosis has no effect on time to BCR and CPRC, because it affects BCR rate, CRPC rate, and CSS, an accurate pathological diagnosis obtained through surgery is beneficial in the treatment of clinical lymph node metastasis prostate cancer.© 2023. Society of Surgical Oncology.