Biologic and clinical significance of lymphadenectomy

Interest in the lymphatic system and its relationship to metastases has dev eloped owing to renewed interest in sentinel node biopsy. This article summ arizes the anatomy, physiology, and biology of the lymphatic system and lym ph node metastases, and reviews studies of lymph node metastases and surgic al resection of cancers in different anatomic sites. On the basis of these studies, the authors conclude that lymph node metastasis functions as an in dicator of prognosis, not the controlling or determining factor of prognosi s. Thus, varying degrees of treatment of regional lymph nodes and metastase s do not seem to be controlling factors in the outcome of cancer.