Downes MR, et al. - Lymph node-positive prostatectomies were retrospectively analyzed in order to determine the relationship of the pattern of nodal metastases with patient outcomes. One hundred and ten cases were determined, ie, ISUP grade (G)5 (n = 52), G4 (n = 8), G3 (n = 34), G2 (n = 10) and no G (n = 6; treatment effect). More than one positive node associated with worse disease-free survival (DFS) and distant metastasis-free survival (DMFS). G in the prostate and nodal metastasis were poorly related. In 33 nodes, the presence of pattern 5 was observed and associated with DFS, disease-specific survival, and DMFS. No prognostic association was revealed by the nodal cribriform pattern and pattern 3 metastasis exhibited a notable trend towards a better outcome. Thus, in 94% of node-positive prostate cancers, intraductal carcinoma or cribriform carcinoma is recognized. However G in the largest nodal metastasis has prognostic importance, its G does not highlight that of the primary prostatic adenocarcinoma.