Histologic confirmation of lesions identified by Prostascint scan following definitive treatment

The purpose of the study was to determine the accuracy of the monoclonal antibody (Mab) [Prostascint, Cytogen, Inc.] scan for the detection of nodal metastases using histologic examination of surgical lymphadenectomy specimens as the standard of reference. We reviewed the records of 31 patients who had undergone biopsy after monoclonal antibody scan. Histologic evaluation was obtained for a total of 31 patients and 43 pathology samples. When analyzed by surgical site, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the Mab scan were 94%, 42%, 53%, 92% and 65%, respectively. When analyzed by individual patient, the same data for the Mab scan were 100%, 33%, 62%, 100% and 68%, respectively. Current noninvasive studies are not sufficiently accurate to reliably determine the presence of metastatic nodal disease from prostate cancer. This series illustrates the importance of rigorous clinical evaluation of future methods that are designed to detect microscopic metastatic disease of any neoplasm.