Intra-operative iodine-125 prostatic implant following bilateral pelvic lymphadenectomy

Sixty-five patients with prostatic adenocarcinoma Stages B and C were treated with intraoperative Iodine-125 prostatic implantation following bilateral pelvic lymphadenectomy. Pelvic nodal metastases were found in 31% of the patients: 23% ( 7 31 ) in clinical Stage B1 disease, 29% ( 8 28 ) in clinical Stage B2, and 83% ( 5 6 ) in clinical Stage C. All the patients have been followed for a period of 1 1 2 to 6 years. Serial digital rectal examination revealed complete regression of the palpable disease in 15% of the patients at 6 months, 47% at I year, and 87% at 2 years. Post-operative complications were also evaluated: 13% of the patients became sexually impotent, 11 % had impaired potency after the procedure, and 16% of patients complained of dry ejaculation; and 17% developed scrotal and/or penile swelling, which persisted up to 14 months, but usually subsided within 5 months. Two patients developed local recurrence. Both patients responded to subsequent external radiation therapy of 7000 rad in 11 to 14 weeks with clinical regression of palpable disease.