Related Experiment Videos
[Reliability of CT for determining lymphatic involvement in patients with prostate cancer]
F H Amo1, F Verdú Tartajo, J M Díez Cordero
1Servicio de Urología, Hospital General Universitario Gregorio Marañón, Madrid, España.
Objective:
To determine the utility of CT in assessment of lymph node metastasis in patients with prostatic cancer.
Methods:
We conducted a retrospective study of 131 patients with prostatic cancer and a negative bone scan, in whom CT was utilized to assess lymph node metastasis. The mean age was 67.7 +/- 7.1 years. Lymphadenectomy of both obturator chains was performed in 85 patients (65%); by surgery in 65 patients (76%) and laparoscopy in 20 (24%).
Results:
6% had a positive CT scan. In the univariate analysis only PSA (p = 0.04) was shown to be a predictive factor for a positive CT. The maximum yield of CT was at cut-off 30 ng/ml PSA; patients with lower values had a negative predictive value of 98%. When lymphadenectomy was performed, 14% of the patients with a negative CT presented lymph node invasion, for a sensitivity of 8%, specificity of 100% and diagnostic accuracy of 86%.
Conclusion:
Due to the scanty prevalence of positive CT scans and its low sensitivity, this imaging technique may be obviated in patients undergoing radical treatment with PSA < or = 30 ng/ml.