I honestly don’t think a surgeon can “see” cancer in a lymph node or not- which is why most of the centers of excellence recommend removing at least six on each side.
Imagine them on a string running from your prostate and down toward the pelvis.
The pathologist examines them sequentially, first to last; if he sees cancer microscopically in the first, he then looks for it in the second and then down the line and so on until he hopefully finds none. If he does find cells then you are usually put on ADT and offered salvage therapy or surveillance.
Not removing a larger number of lymph glands is controversial. My surgeon, for instance, only removed the closest one to the gland ( I believe it was called the “bullseye node” in the path report) and I learned later that he was sued by some patients for doing just that.
Man, was I pissed!! But after going on various forums I discovered that a lot of surgeons do this for one reason or another.
I don’t agree with it or like it, but I am not a cancer surgeon so who am I to say?