[Gleason's system and pelvic lymphadenectomy in the pretherapeutic evaluation of XXXX . Apropos of 85 cases].

@entity1 @entity263
Accuracy of staging of @entity263 is related to invasive procedures since imaging methods do not allow a reliable knowledge of the nodal status. Unfortunately lymphadenectomy is adversely affected by morbidity and mortality, therefore alternative methods should be elaborated. Post-lymphographic aspiration cytology seems to be worthwhile, having proved to be a reliable, accurate, safe procedure which can provide useful information in the management of @entity1 with @entity263 . Nevertheless uncertainty exists upon the clinical significance of negative cytologic findings. In this connection correlation between grading and aspiration cytology can constitute a further improvement. In our experience the Gleason grading system has shown to be the most reliable and reproducible. 85 @entity1 classified according to the Gleason's system, underwent staging lymphadenectomy and no nodal metastases were present when the Gleason score was lower than 5. In 50 cases even aspiration cytology was accomplished before surgery. No false positive cytologic findings were seen on histologic verification. Two false negative results were obtained in @entity1 with Gleason score higher than 5. In conclusion we believe that when @entity263 shows a Gleason score lower than 5 and the lymph node aspiration cytology is negative no staging lymphadenectomy should be performed. On the contrary in cases with Gleason sum from 5 to 10 negative nodal cytologic findings are inconclusive, nevertheless this rate of @entity1 is low and the necessity of surgical staging can be really reduced.
