Managing Clinical N1 Prostate Cancer.

Clinical lymph node positive prostate cancer refers to prostate adenocarcinoma with metastasis to regional lymph nodes detected prior to definitive therapy. This is an aggressive cancer with varying presentations and prognosis. Thorough diagnostic imaging is key to establishing this stage of cancer, carefully distinguishing it from distant metastatic disease. The mainstay of therapy is multimodal treatment, typically surgery + radiation + hormone therapy or radiation therapy + hormone therapy. Treatment individualization is important, both surgery and radiation-based strategies can be effective when appropriately combined with androgen deprivation therapy.