This is true before radical prostate surgery unless the patient decides
for an aggressive lymhadenectomy prior to surgery. This is maybe
indicated in cases in the grey diagnostic zone, but surely not very
common and only in very aggressive patients.
After normal radical surgery and lymph node inspection there are several
papers to correlate patient's prognosis. In every case the higher the
tumor burden the higher the probability of disease progression and
reduced survival.
I think that as imaging becomes more and more accurate, this knowledge
will be beneficial to those making treatment decisions in the future.
This once is proven that aggressive therapies do indead promote a
survival benefit. This will take a few years...
Best regards,
RalphV
====> hi ralph - i'll add my .02 cents worth on this thread.
on the thread itself, Nodal status is best predictor of outcome after
neoadjuvant therapy for esophageal cancer
The number of lymph nodes that contain evidence of cancer is the best
predictor of the effectiveness of adding chemotherapy and radiation to a
treatment plan prior to surgery in individuals with oesophageal cancer,
according to a study published last month in the Annals of Surgery.
http://theanalystmagazine.com/pr/951.htm
===> first, i would have to say that we are talking about apples and
oranges, even though it is in the same body. and secondly, i would
have to say we are talking about a similar situation. so, while this
sounds like double speak, i'll take the time and effort to explain.
to start with, lymph nodes are lymph nodes. they are all over the body
and they have a function. but individuals with oesophageal cancer do
not have a place for the cancer to start inside -like a prostate gland,
and chew it's way out and then into the lymph nodes.
which makes the point of the poster's article. by examining the lymph
nodes, you can get an idea of just how involved the oesophageal cancer
is.
but in the case of prostate cancer, if you want to call it lucky, we
have a gland where the cancer starts inside and we have a chance of
better survival by catching it before it can get to the lymph nodes
which on in the prostate bed area.
while we hear pros and cons about different types of pca treatments,
there is one small difference in pca surgeries.
robotic and LRP surgeries can make smaller openings, the surgeon can
not tell by looking at a lymph node, if it has cancer in it, but on the
open RP, the surgery has an advantage and can tell by touch. this is
what my surgeon told me when he operates. by being able to feel the
lymph node, he could not only tell if it had cancer inside it, but how
far it had traveled. while i'm sure it's not 100% accurate, it does
lend itself to a better chance of survival, but i've never heard of any
articles pursuing this line of thought.
now, back to the thread of oesophageal cancer. the precancerous
condition is called barrett's esophagus, which leads into cancer.
before, all the patient could do was wait and see if they developed
oesophageal cancer. and we thought having an elevated psa with a
negative biopsy was bad.
now, there is a new treatment out that was just announced this past
week. the surgeon uses a small inflatable tube with a bulb on it, down
to where the barrett's condition is and it has a heater in the blub. he
inflates the bulb and turns on the current. the bulb heats up and burns
the inner lining of the esophagus. this causes the lining to shed and
along with it, the precancerous cells. the outcome from this new type
of treatment is very positive.
~ curtis
knowledge is power - growing old is mandatory - growing wise is optional
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."
http://community.webtv.net/PALMER_ENT/doc 
Nodal status is best predictor of outcome after neoadjuvant therapy for esophageal cancer 
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