Pelvic lymph nodes and pathways of disease spread in male pelvic malignancies

Purpose Accurate nodal staging for male urogenital malignancies has important implications for therapy and prognosis. Male pelvic malignancies, including prostatic, penile, testicular, and bladder cancer, typically metastasize to regional lymph nodes first which is reported by the N-stage. Spread beyond these groups to non-regional nodes is regarded as M-stage disease. Methods In this review, we discuss the typical patterns of male pelvic lymphatic drainage and the tumor-specific regional nodal chains. Results The impact of tumor-specific imaging features and the implications of previous treatments on staging are discussed. Conclusions While anatomic imaging, including CT and MRI, is the most widely employed imaging modality at present, newer functional imaging techniques have demonstrated promise in the accurate identification and characterization of nodal metastases.