Lymph node positive prostate cancer: the evolving role of adjuvant therapy

For decades, lymph node metastasis (LNM) at the time of radical prostatectomy (RP) has been considered as a poor prognostic sign. Currently, the appropriate timing for androgen deprivation therapy (ADT) remains controversial. Only one small prospective randomized study (ECOG 3886) has shown improved survival for immediate vs. delayed ADT in this select group of patients (1).