Carcinoma of the prostate: lymph node aspiration for staging

Accuracy of Transcutaneous Aspiration Biopsy in the Definitive Assessment of Nodal Involvement in Prostatic Carcinoma

“…Only 15 of these patients subsequently underwent pelvic lymph node dissection. In a series of 33 patients with clinically localised prostatic carcinoma, Efremidis et al (1981) carried out TAB of a11 suspect nodes after lymphography resulted in a cytological diagnosis of metastasis in 20 cases (60%). Histological nodal pelvic examination was performed in only three patients with negative cytology but confirmed the cytological diagnosis.…”

The Value and Role of Percutaneous Pelvic Lymph Node Aspiration Biopsy in Definitive Staging of Prostatic and Bladder Carcinoma

“…Pelvic lymphadenectomy has replaced bipedal lymph angiography as the definitive means of diagnosing lymph node metastasis of prostatic cancer. The removal of pel vic nodes has a morbidity in 20-30% of the patients and the mortality rate may be 1 % [2,8,9,14], In the manage ment of bladder cancer, pelvic lymphadenectomy is not a current staging procedure and it has recently been sug gested that the operation does not increase the morbidity associated with cystectomy, and that it has a therapeutic effect in the control of local and regional disease [6,26,27], In patients with prostatic carcinoma the percuta neous fine-needle aspiration biopsy has been proposed as a noninvasive, innocuous, diagnostic method, alternative to surgical staging [4,5,7,12,13,17,18,24,28,[30][31][32], On the other hand we were unable to find any specific reference to the value and accuracy of biopsy aspiration in the management of bladder carcinoma. In the present series of 26 patients with prostatic carcinoma, the high overall accuracy [96.15%) and specificity (100%) of fineneedle biopsy aspiration demonstrate the reported value of this procedure as definite diagnostic means in deter mining tumor stage.…”

“…In the reported series of pelvic node aspiration biopsies in patients with urological neoplasms [4,5,7,12,21,24,30], a control pelvic lymphadenectomy was rarely performed. It is evident that the effectiveness of aspiration biopsy should be assessed by histologic control [17].…”

“…The per cutaneous fluoroscopy-guided aspiration biopsy of pelvic nodes has been proposed as a noninvasive, alternative procedure to surgical staging in determining or excluding the nodal involvement of prostatic carcinoma [4,5,7,12,13,17,18,21,24,[29][30][31], In patients with prostatic carci noma a positive cytology from the aspirate is always consid ered diagnostic of stage D disease [5,7,30]. The negative cytologic findings do not completely exclude the nodal extension of the tumor, since not all nodes are opacified by the lymphangiography and therefore cannot be aspirated [5,7,30]. In the management of bladder carcinoma, pelvic lymphadenectomy is not a frequent staging procedure [10, Lymph Node Aspiration Biopsy in Staging of Prostatic and Bladder Carcinoma A B…”