Utility of preoperative serumprostate-specific antigen concentration and biopsy Gleason score in predicting risk of pelvic lymph node metastases in prostate cancer

Narayan, Perinchery; Fournier, George R.; Gajendran, Viswanathan; Leidich, Raymond B.; Lo, Richard Hoau Gong; Wolf, J. Stuart; Jacob, G.; Nicolaisen, Gary; Palmer, Keith W.; Freina, Fuad

doi:10.1016/s0090-4295(94)80050-2

Cited by 94 publications

(44 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In 1993, Sullivan and Rabbani [12] found no positive lymph nodes in 95 consecutive patients who had a PSA level of <10 ng/mL and a Gleason score of <8/10; these results are consistent with others [13,14]. In a similar Accepted for publication 7 September 1999 BJU International (2000), 85, 95±100 study, Weldon et al [15] found that pelvic lymphadenectomy could be eliminated in 58% of their cohort of 200 patients with clinical stages fT2b, a biopsy Gleason score of <7 and a PSA level of <12 ng/mL, for a nodenegative predictive value of 99%.…”

Section: Introductionsupporting

confidence: 73%

A comparison of the relative merits of radical perineal and radical retropubic prostatectomy

Sullivan

Weir²,

Kinahan

et al. 2000

BJU International

View full text Add to dashboard Cite

Objective To compare the outcome, advantages and disadvantages of retropubic and perineal approach to radical prostatectomy, as performed by one surgeon. Patients and methods This unrandomized study included 138 patients who underwent either radical retropubic (RRP) or radical perineal prostatectomy (RPP), based on the speci®c conditions or the patient's choice; 79 patients (mean age 64.6 years) underwent RPP and 59 (mean age 61.7 years) RRP. Outcome measures included estimated blood loss, the incidence of blood transfusions, positive margins and complications, operative duration, analgesic use, days in hospital and quality of life. Results There was no difference in operative duration, and the incidence of positive margins or complications between the groups. The mean estimated blood loss in the RPP and RRP groups was 415 and 1138 mL, respectively. The RPP group stayed a mean of 2.2 days less in hospital and took 2.8 days less to regain a full diet than the RRP group; the RPP group needed 1.7 days before using oral analgesics and the RRP group 3.8 days. Of patients in both groups, 85% were pad-free at one year and their overall quality of life was similar. Conclusions The results of RRP and RPP are comparable; the advantages of the perineal approach include minimal blood loss, low-intensity postoperative nursing care, low analgesic use and earlier discharge from hospital.

show abstract

Section: Introductionsupporting

confidence: 73%

A comparison of the relative merits of radical perineal and radical retropubic prostatectomy

Sullivan

Weir²,

Kinahan

et al. 2000

BJU International

View full text Add to dashboard Cite

show abstract

“…Se están realizando exámenes de alto costo económico, y con exposición a radiación ionizante a pacientes que obtienen un beneficio marginal de estos estudios. De acuerdo a la evidencia presentada, los pacientes de bajo riesgo no tienen lesión secundaria al momento del diagnóstico [8][9][10] . Esto significa que un alto volumen de pacientes se somete a exámenes radiológicos, sin una clara justificación y sin un beneficio objetivo claro.…”

Section: Discussionunclassified

“…En una investigación en 932 pacientes, en los que se realizó una prostatectomía más disección ganglionar, no se encontró compromiso metastásico en ninguna de las muestras con Gleason ≤ 5 9 . Así mismo, otros estudios en pacientes con puntaje de Gleason ≥ 8, evidencian un mayor número de casos con diseminación secundaria 10 , lo que revela su rol predictor de riesgo de metástasis.…”

unclassified

¿Es necesario realizar un estudio de etapificación en todos los pacientes con cáncer de próstata?: Experiencia de un centro clínico nacional

M¹,

Calvo

Ibarra

et al. 2017

Rev. méd. Chile

View full text Add to dashboard Cite

“…Parra et al 16 assigned 74 of 155 men to a low-risk group (PSA level ϭ 10 ng/mL; Gleason score Ͼ 7); 40 of those 74 men underwent lymph node staging without a single positive lymph node. Narayan et al, 17 accepting a false negative rate of 1%, classified 42% of their patients in a low-risk group, whereas Bishoff et al 18 classified 51% of their patients into a low-risk group, although the latter authors permitted a high false negative rate of 5%. If their false negative rate should not exceed 2%, then only 20% of their patients could be classified as low-risk patients.…”

Section: Discussionmentioning

confidence: 99%

Validation of a biopsy‐based pathologic algorithm for predicting lymph node metastases in patients with clinically localized prostate carcinoma

Haese

Epstein

Huland

et al. 2002

Cancer

View full text Add to dashboard Cite

BACKGROUNDThe authors validated an algorithm for the preoperative prediction of lymph node (LN) metastases in patients with clinically localized prostate carcinoma. The algorithm was applied to sextant biopsy material and radical retropubic prostatectomy (RRP) stage obtained from a cohort of men who were treated at the authors' institution.METHODSFour hundred forty‐three patients underwent systematic sextant biopsy and RRP with staging lymphadenectomy. The original algorithm was based on systematic sextant biopsy data and classified patients into three risk groups for LN metastases based on the biopsy result. If ≥ 4 of 6 biopsies contained any Gleason Pattern 4 disease, then the patient was at high risk for LN metastases (45%). Patients with ≥ 1 of 6 biopsies with dominant Gleason Pattern 4 disease (excluding high‐risk patients) had an intermediate predicted risk (19%) of LN metastases. All other patients had a low predicted risk of LN metastases (2.2%). The authors assed the percentage of patients who were positive and negative for LN metastases and calculated the specificity and negative predictive value in the series when patients were classified according to the original algorithm.RESULTSTwenty of 443 patients had intraoperative LN metastases. When applied to the current data, the Hamburg algorithm classified 404 patients in the low‐risk group, 30 patients in the intermediate‐risk group, and 9 patients in the high risk group. The incidence of LN metastases was 2.47% in the low‐risk group, 20% in the intermediate‐risk group, and 44.4% in the high‐risk group. The negative predictive value for the low‐risk group was 97.52%, and the specificity was 94.14%.CONCLUSIONSThe Hamburg algorithm proved a valid tool for the prediction of lymphatic spread in this validation study on data from the authors' institution. The algorithm may serve as a tool to select patients who do not need to undergo pelvic lymphadenectomy at the time they undergo RRP, hence reducing morbidity and expense. More importantly, with the increasing numbers of men undergoing treatment options in whom LN dissection is not performed, this validated algorithm provides an important selection basis regarding the appropriateness of a therapy that does not routinely include LN staging. Cancer 2002;95:1016–21. © 2002 American Cancer Society.DOI 10.1002/cncr.10811

show abstract

Utility of preoperative serumprostate-specific antigen concentration and biopsy Gleason score in predicting risk of pelvic lymph node metastases in prostate cancer

Cited by 94 publications

References 24 publications

A comparison of the relative merits of radical perineal and radical retropubic prostatectomy

A comparison of the relative merits of radical perineal and radical retropubic prostatectomy

¿Es necesario realizar un estudio de etapificación en todos los pacientes con cáncer de próstata?: Experiencia de un centro clínico nacional

Validation of a biopsy‐based pathologic algorithm for predicting lymph node metastases in patients with clinically localized prostate carcinoma

Contact Info

Product

Resources

About