Limitations of Radioguided Surgery in High-Risk Prostate Cancer

Weckermann, Dorothea; Dorn, R.; Höll, G.; Wagner, T.; Harzmann, R.

doi:10.1016/j.eururo.2006.08.049

Cited by 85 publications

(45 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Se realizó LDNP extendida de forma complementaria a la LDNP del GC en 228 hombres con cáncer de próstata de alto riesgo 13 . De estos pacientes, 96 tuvieron metástasis ganglionares, y tan sólo en 2 no se detectaron mediante la LDNP del GC.…”

Section: Resultsunclassified

“…El tiempo medio de cirugía fue de 51 minutos (28-97). Se obtuvieron un total de 540 GC con una mediana de 4 por paciente (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). La correlación entre la localización del GC preoperatoria e intraoperatoria mediante gammagrafía y metástasis ganglionares fue del 79% (15/19) y 90% (17/19) respectivamente.…”

Section: Resultsunclassified

“…El número de ganglios positivos en nuestra experiencia se corresponde con la de otros grupos que realizan ambos procedimientos 2,3,12,13 . Cuando la literatura actual estima la incidencia de adenopatías positivas entre el 2-7%, se basan en trabajos en los que se ha utilizado LDNP limitada 15,16 .…”

Section: Discussionunclassified

See 2 more Smart Citations

Papel de la biopsia dinámica del ganglio centinela en el cáncer de próstata organoconfinado

et al. 2007

View full text Add to dashboard Cite

RESUMENPAPEL DE LA BIOPSIA DINÁMICA DEL GANGLIO CENTINELA EN EL CÁNCER DE PRÓSTATA ORGANOCONFINADO La correcta valoración de la afectación ganglionar es de gran importancia en el manejo de los nuevos casos de cán-cer de próstata. El estadio precoz de la enfermedad metastásica se manifiesta como pequeños focos microscópicos más que como ganglios linfáticos engrosados. Sin embargo, hasta ahora no hay ninguna técnica de imagen que permita detectar metástasis cuyo diámetro alcance unos pocos milímetros. Por tanto, la linfadenectomía pélvica (LNDP) es el único método fiable para el estadiaje del cáncer de próstata organoconfinado (CPO).El pilar de la cirugía prostática radioguiada es el uso de un radiofármaco, una molécula transportadora marcada con radionúclido. Tras la inyección en la glándula prostática, el radiofármaco alcanza el territorio linfático y migra al primer escalón linfático, el ganglio centinela (GC). Fuimos los primeros en demostrar que la LDNP del GC se podía llevar a cabo mediante abordaje laparoscópico previo a la prostatectomía radical (PTR) laparoscópica. En nuestra publicación más reciente se presentan los datos de 140 pacientes diagnosticados de CPO entre noviembre de 2001 a enero 2005 en los que se realizó LDNP laparoscópica del GC previa a la PTR, también laparoscópica 14 . En la gammagrafía preoperatoria, se detectaron GC de forma bilateral en 113 pacientes (80,7%), de forma unilateral en 20 (14,2%) y no se detectaron en 6 (4,2%), mientras que en la realizada durante la cirugía se detectaron en 96 pacientes (68,6%), 36 (25,7%), 8 (5,7%) respectivamente. Los GC se hallaron en la misma localización con ambos procedimientos en 99 de 140 pacientes (70,7%). Al menos se objetivó un GC en 133 pacientes (95,3%).Cuando la LDNP está indicada, ésta no debería restringirse a la exéresis de adenopatías, según la técnica de LDNP limitada o estándar, sino que tiene que realizarse siguiendo el patrón de la LDNP extendida. Hay poca experiencia con la LDNP del GC, pero todos los datos publicados hasta ahora indican que este procedimiento puede ser una alternativa a la LDNP extendida, ya que permite reducir la extensión de la LDNP sin comprometer la exactitud diagnóstica.Palabras clave: Ganglio centinela. Linfadenectomía pélvica. Cáncer de próstata organoconfinado. ABSTRACT SENTINEL LYMPH NODE DISSECTION FOR LOCALIZED PROSTATE CANCERProper assessment of lymph node status is of crucial importance in the management of newly diagnosed prostate cancer. Early stage metastatic disease takes the form of microscopic tumor-cell deposits rather than grossly enlarged nodes. So far there is no imaging technique, however, which allows detecting small metastases in the range of a few millimetres. Therefore pelvic lymph node dissection (PLND) is the only reliable method of staging for clinically localized prostate cancer. The cornerstone of radioguided prostate surgery is a radiopharmaceutical -a carrier molecule labeled by radionuclide. After injection to at the prostate, the radiopharmaceutical crosses the lymphatic pores...

show abstract

Section: Resultsunclassified

See 1 more Smart Citation

Papel de la biopsia dinámica del ganglio centinela en el cáncer de próstata organoconfinado

et al. 2007

View full text Add to dashboard Cite

show abstract

“…Another shortcoming is that the small number of patients included leads to a wide confidence interval for the estimate of the sensitivity of the method. Also, a general limitation of the SN technique is that in some patients with large lymph node metastases, it is not possible to identify the true SNs due to the presence of tumour cells obstructing the lymphatic vessels, causing a re-routing of the lymphatic pathways and thereby false-negative SNs (30).…”

Section: Discussionmentioning

confidence: 99%

Simplified intraoperative sentinel-node detection performed by the urologist accurately determines lymph-node stage in prostate cancer

Kjölhede

Bratt

Guðjónsson

et al. 2014

Scandinavian Journal of Urology

View full text Add to dashboard Cite

Simplified intraoperative sentinel-node detection performed by the urologist accurately determines lymph-node stage in prostate cancer.Kjölhede, Henrik; Bratt, Ola; Gudjonsson, Sigurdur; Sundqvist, Pernilla; Liedberg, Fredrik Link to publication Citation for published version (APA): Kjölhede, H., Bratt, O., Gudjonsson, S., Sundqvist, P., & Liedberg, F. (2015). Simplified intraoperative sentinelnode detection performed by the urologist accurately determines lymph-node stage in prostate cancer. Scandinavian Journal of Urology, 49(2), 97-102. DOI: 10.3109/21681805.2014.968867 General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal is currently an extended pelvic lymph node dissection (ePLND), which detects the majority, but not all, of regional lymph node metastases. As an alternative to ePLND, sentinel node (SN) dissection with preoperative isotope injection and imaging has been reported. The objective was to determine whether intraoperative SN detection with a simplified protocol can accurately determine lymph node stage in prostate cancer patients. Materials and methods:Patients with biopsy-verified high-risk prostate cancer with tumour stage T2-3 were included in the study. All patients underwent both ePLND and SN detection. 99m Tc-marked nanocolloid was injected peritumourally by the operating urologist after induction of anaesthesia just prior to surgery. SNs were detected both in-vivo and ex-vivo intraoperatively using a gamma probe. SNs and metastases and their locations were recorded. Sensitivity and specificity were calculated.Results: At least one SN was detected in 72 (87%) of the 83 patients. In 13 (18%) of these 72 patients SNs were detected outside the ePLND template. In six of these 13 patients, the SNs from outside the template contained metastases, which proved to be the only metastases in two. For 12 patients the only metastatic deposit found was a micrometastasis (≤ 2 mm) in a SN. In the 72 patients with detectable SNs, pathological analysis of the SNs correctly categorised 71 and ePLND 70 patients. Conclusions:This protocol yielded results comparable to the commonly used technique of SN detection, but with more cases of non-detection.

show abstract

“…The false-negative rate was shown to correlate with Gleason scores [21]; patients with high-risk disease could thus have both positive SLNs and positive non-SLNs or LNI only in non-SLNs. In a study by Weckermann et al, only positive non-SLNs were identified (false-negative results) by radioisotope-guided sPLND in two of 96 men with positive LNs (2.1%) [24]. Therefore, a lower median sensitivity and a higher false-negative rate was observed in studies including only patients at higher risk of LNI [11].…”

Section: Discussionmentioning

confidence: 99%

Magnetic Marking and Intraoperative Detection of Primary Draining Lymph Nodes in High-Risk Prostate Cancer Using Superparamagnetic Iron Oxide Nanoparticles: Additional Diagnostic Value?

Winter

Engels

Reinhardt

et al. 2017

Preprint

View full text Add to dashboard Cite

Sentinel lymph node dissection (sLND) using a magnetometer and superparamagnetic iron oxide nanoparticles (SPIONs) as a tracer was successfully applied in prostate cancer (PCa). Radioisotope-guided sLND combined with extended pelvic LND (ePLND) achieved better node removal, increasing the number of affected nodes or the detection of sentinel lymph nodes outside the established ePLND template. We determined the diagnostic value of additional magnetometer-guided sLND after intraprostatic SPION-injection in high-risk PCa. This retrospective study included 104 high-risk PCa patients (PSA >20 ng/ml and/or Gleason score ≥8 and/or cT2c) from a prospective cohort who underwent radical prostatectomy with magnetometer-guided sLND and ePLND. The diagnostic accuracy of sLND was assessed using ePLND as a reference standard. Lymph node metastases were found in 61 of 104 patients (58.7%). sLND had a 100% diagnostic rate, 96.6% sensitivity, 95.6% specificity, 96.6% positive predictive value, 95.6% negative predictive value, 3.4% false negative rate, and 4.4% false positive rate (detecting lymph node metastases outside the ePLND template). These findings demonstrate the high sensitivity and additional diagnostic value of magnetometer-guided sLND, exceeding that of ePLND through the individualized extension of PLND or the detection of sentinel lymph nodes / lymph node metastases outside the established node template in high-risk PCa.

show abstract

Limitations of Radioguided Surgery in High-Risk Prostate Cancer

Cited by 85 publications

References 20 publications

Papel de la biopsia dinámica del ganglio centinela en el cáncer de próstata organoconfinado

Papel de la biopsia dinámica del ganglio centinela en el cáncer de próstata organoconfinado

Simplified intraoperative sentinel-node detection performed by the urologist accurately determines lymph-node stage in prostate cancer

Magnetic Marking and Intraoperative Detection of Primary Draining Lymph Nodes in High-Risk Prostate Cancer Using Superparamagnetic Iron Oxide Nanoparticles: Additional Diagnostic Value?

Contact Info

Product

Resources

About