World J UroI (1997) 15:346-358 © Springer-Verlag 1997

Stage Tlc prostate cancer: defining the appropriate staging evaluation and the role for pelvic lymphadenectomy Abstract A good staging system should be able to ac-curately reflect the natural history of a malignant dis-ease, to express the extent of the disease at the time of diagnosis, and stratify patients in prognostically dis-tinctive groups. The staging system for prostate cancer, as it is today, fails to fulfill these requirements. Ap-proximately one third of the patients who undergo sur-gery for complete xcision of prostate cancer in fact do not have a localize disease. The incidence of tumor at the inked margin may reach 30 % for T1 stage and up to 60 % for clinical T2b prostate cancer according to comparision with pathologic examination of resected specimen. Several concepts have been recently proposed as a means of improving the accuracy of the available staging system. In this paper, we review current aspects of clinical and pathological staging of prostate cancer, and the importance of these new concepts on the early stages of prostate cancer. Prostate cancer (PCa) is a frequent and deadly malig-nancy that has become a major health concern for so-ciety, physicians, and health organizations worldwide. In the United States an estimated 334,500 new cases of prostate cancer (PCa) will be diagnosed and 41,800 men are expected to perish from this disease in 1997 [68]. For this reason, clinicians and researchers have joined efforts to improve our understanding of this disease process. As a result, the diagnosis and staging of PCa has been in a state of evolution over the past two decades. In addition