Geographical distribution of lymph node metastases on MR lymphography in prostate cancer patients

Meijer, Hanneke; Fortuin, Ansje S.; Lin, Emile N.J.T. van; Debats, Oscar A.; Witjes, J. Alfred; Kaanders, Johannes H.A.M.; Barentsz, Jelle O.

doi:10.1016/j.radonc.2012.10.021

Cited by 40 publications

(28 citation statements)

References 24 publications

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“…All other patients had LN outside these areas or detectable BM at the time of metastatic diagnosis by WB‐MRI. This confirms recent observations made with MRI and PET based imaging and questions surgical and EBRT templates in the management of high‐risk PCa . With a wider use of these new imaging detection techniques, physicians will progressively convert from standard arbitrary templates to individualized (“personalized”) image‐based LN irradiation for high‐risk patients .…”

Section: Discussionsupporting

confidence: 81%

Whole body MRI (WB‐MRI) assessment of metastatic spread in prostate cancer: Therapeutic perspectives on targeted management of oligometastatic disease

et al. 2016

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Non-invasive mapping of metastatic landing sites in PCa using WB-MRI/DWI shows that 28% of the mHNPC patients, and 52% of the mCRPC can be classified as oligometastatic, thus challenging the concept of metastatic targeted therapy. More than two thirds of metastatic patients have LN located outside the usually recommended targets of eLND and pelvic EBRT. Prophylactic or salvage treatments of these sole areas in patients with high-risk prostate cancer may not prevent the emergence of subsequent metastases. Prostate 76:1024-1033, 2016. © 2016 Wiley Periodicals, Inc.

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Section: Discussionsupporting

confidence: 81%

Whole body MRI (WB‐MRI) assessment of metastatic spread in prostate cancer: Therapeutic perspectives on targeted management of oligometastatic disease

et al. 2016

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“…However, because none of these are yet widely available, they cannot be recommended as part of the current standard of care. Similarly, progress has been made in imaging lymph nodes with ultrasmall particles of iron oxide combined with MRI, as normal lymph nodes will take up the agent and turn dark, but abnormal lymph nodes will not . However, this technique, termed magnetic resonance lymphography, although able to depict lymph nodes outside of the normal surgical template, is also still investigational …”

Section: Areas For Further Researchmentioning

confidence: 99%

Prostate cancer – major changes in the American Joint Committee on Cancer eighth edition cancer staging manual

Buyyounouski

Choyke

McKenney

et al. 2017

CA A Cancer J Clinicians

293

191

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Answer questions and earn CME/CNE The eighth edition of the American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) Staging Manual has been updated and improved to ensure the highest degree of clinical relevance and to improve its utility for patient evaluation and clinical research. Major changes include: 1) pathologically organ-confined disease is now considered pT2 and is no longer subclassified by extent of involvement or laterality, 2) tumor grading now includes both the Gleason score (as in the seventh edition criteria) and the grade group (introduced in the eighth edition criteria), 3) prognostic stage group III includes select, organ-confined disease based on prostate-specific antigen and Gleason/grade group status, and 4) 2 statistical prediction models are included in the staging manual. The AJCC will continue to critically analyze emerging prostate cancer biomarkers and tools for their ability to prognosticate and guide treatment decision making with the highest level of accuracy and confidence for patients and physicians. CA Cancer J Clin 2017;67:245-253. © 2017 American Cancer Society.

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“…Studies using the sentinel node procedure or MRL to map the pattern of lymph drainage in prostate cancer patients, have shown that this is a larger problem than was previously thought. Positive lymph nodes and sentinel nodes were found outside the area of routine lymph node dissection [16], as well as outside the standard target volume for elective pelvis irradiation in more than half of the patients [17,18]. The possibility to target pathological lymph nodes more accurate, will increase the effectiveness of locoregional treatment in these patients.…”

Section: Discussionmentioning

confidence: 99%

A retrospective analysis of the prognosis of prostate cancer patients with lymph node involvement on MR lymphography: who might be cured

et al. 2013

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BackgroundThe prognosis of prostate cancer patients with lymph node metastases so small they can only be visualized by new imaging techniques as MR lymphography (MRL) is unknown. The purpose of this study was to investigate the prognosis of prostate cancer patients with non-enlarged metastatic lymph nodes on MRL and to identify a subgroup of MRL-positive patients who might be candidates for curative treatment.MethodsThe charts of 138 prostate cancer patients without enlarged lymph nodes on CT, in whom a pre-treatment MRL was performed were reviewed. Endpoints were distant metastases-free survival and overall survival. Relation between the following factors and outcome were investigated: T-stage, PSA value at diagnosis, Gleason score, diameter (short axis and long axis) of the largest MRL-positive lymph node, number of MRL-positive lymph nodes, the presence of extra-pelvic nodal disease, and the extent of resection of the positive lymph nodes. Kaplan-Meier analysis was performed to estimate the survival functions.ResultsOf the 138 patients, 24 (17%) had a positive MRL. Patients with a short axis of the largest positive lymph node of ≤8 mm had a significantly better 5-year distant metastases-free (79% vs 16%) and overall survival (81% vs 36%) than patients with larger positive lymph nodes. This also accounted for patients with a largest long axis of ≤10 mm (71% vs 20% and 73% vs 40%, respectively). Outcome was also better in patients in whom all positive lymph nodes had been resected.ConclusionA selection of MRL-positive patients with a good prognosis could be identified, consisting of patients with small positive lymph nodes. In these patients, cure might be pursued.

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Geographical distribution of lymph node metastases on MR lymphography in prostate cancer patients

Cited by 40 publications

References 24 publications

Whole body MRI (WB‐MRI) assessment of metastatic spread in prostate cancer: Therapeutic perspectives on targeted management of oligometastatic disease

Whole body MRI (WB‐MRI) assessment of metastatic spread in prostate cancer: Therapeutic perspectives on targeted management of oligometastatic disease

Prostate cancer – major changes in the American Joint Committee on Cancer eighth edition cancer staging manual

A retrospective analysis of the prognosis of prostate cancer patients with lymph node involvement on MR lymphography: who might be cured

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