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In consequence, tumor characteristics in these patients could be different.15 The current series represents the first and largest population-based study using a North American cohort assessing the correlation between LN count and the rate of pN1 stage. The present findings have important clinical implications. The positive relationship between increasing LN count and the rate of pN1 was independent of serum PSA value, tumor stage and/or grade. Therefore, if the aim of a PLND is to obtain an accurate https://en.wikipedia.org/wiki/Crotamiton staging, an extended procedure should be invariably carried out. In order to achieve a high LN count, the PLND limits should be the genitofemoral nerve laterally, the medial aspect of the obturator fossa up to the perivesical fat, the deep circumflex vein and the femoral canal distally. The proximal dissection should include the fibrofatty tissue at the bifurcation of the common iliac artery. Finally, the lymph nodes along the internal iliac artery should be also removed.4 According to the present findings, a LN count of 20 nodes at the final RP pathological specimen examination allows a correct staging in approximately 90% of cases. Such a cut-off can be considered http://www.selleckchem.com/products/CP-673451.html adequate for most surgeons. Nevertheless, the most acceptable cut-off can vary according to surgeon�Cpatient preferences. In such a case, the present results can be used to determine the accuracy of the selected cut-off (Fig.?2). It is noteworthy that in low-risk tumors, an extended PLND might not represent the most cost-effective option, given the extremely low rate of pN1 in these patients (0.2%). Conversely, patients with intermediate or high-risk tumors might benefit the most from an extended PLND. An extended PLND allows an accurate lymph node staging that permits a prompt identification of patients with pN1 disease. These http://www.selleckchem.com/products/rxdx-106-cep-40783.html patients might benefit from an adjuvant hormonal therapy that may improve their cancer control outcomes.16 In addition to its diagnostic role, PLND might also have a therapeutic role. In a recent report based on the SEER data, we observed that pNx patients had a 1.3-fold higher CSM rate than their pN0 counterparts (P?