<p><strong> </strong><strong>Clinicians should complete a radical prostatectomy if suspicious regional nodes are encountered intraoperatively. <em>(Moderate Recommendation; Evidence Level: Grade C)</em></strong></p>
Discussion
Discussion
<p>The Panel acknowledges the absence of prospective trial testing in this setting. Numerous retrospective series – largely in historic cohorts of patients from an era during which frozen section analysis of pelvic lymph nodes at the time of prostatectomy was routine – have reported a benefit to completion of radical prostatectomy among patients found to have positive nodes versus patients whose surgery was aborted and who were then treated with ADT alone.<sup>199-202</sup> Recognizing the design/methodologic limitations of these studies, the Panel believes that completion of surgery remains warranted among patients for whom lymph nodes suspicious for harboring malignancy are encountered during surgery, particularly given the overall demonstrated safety of radical prostatectomy in contemporary series.<sup>203</sup></p>