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Query: UMLS:C0376358 (prostate cancer)
 59,338 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Lymphangiography and staging lymphadenectomy were performed in 36 patients with carcinoma of the prostate. The accuracy of lymphangiography was 75% with a specificity of 79% and a sensitivity of 67%. The results of nodal metastases in relation to grade and stage of the tumor are compared with literature. Applications for lymphangiography in prostatic cancer are discussed.
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PMID:The role of lymphangiography in the staging of prostatic cancer. 732 75

Clinically occult lymph node metastases are a frequent finding in patients with carcinoma of the prostate. At present, lymph node dissection is the only reliable method of detecting local nodal spread; we have investigated a nonsurgical technique for demonstrating nodes using intraprostatic injections of 99mTc-Sb2S3. 99mTc-Sb2S3 (1.0 mCi/0.1--0.2 ml) was injected into the prostate glands of nine male mongrel dogs. Scintillation camera images revealed from one to four lymph nodes in each animal with earliest nodal visualization at 1 hour. A study performed on a 64-year-old man with prostatic cancer allowed visualization of seven pelvic lymph nodes, all of which were found to be histologically normal. The simplicity of this technique suggests the potential for both pre- and intraoperative identification of the prostatic lymph nodes. Clinical trials presently underway will allow assessment of the sensitivity and specificity of this technique for the detection of nodal metastases.
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PMID:Visualization of canine and human prostatic lymph nodes following intraprostatic injection of technetium-99m-antimony sulfide colloid. 735 41

One hundred forty-nine lymphograms from patients with localized carcinomas of the prostate were interpreted by a referee radiologist without the benefit of clinical stage, grade of tumor, or the result of staging pelvic node dissection. The lymphogram was able to detect 30 of 35 (86%) positive nodal metastases and confirm 90 of 114 (79%) negative nodal biopsies. The internal iliac nodal biopsies were positive as a single finding in only 7 of 54 (13%) patients. The total external iliac nodal involvement was 41 of 54 (76%). High-grade prostate cancer patients have twice the incidence of positive nodal biopsies and lymphograms. Lymphography detected 43% of positive nodal patients with normal acid phosphatase and 69% of positive nodal patients with elevated acid phosphatase determinations. The lymphogram and tumor grade (prostate) are considered significant potential predictors of lymph node biopsy result. Finally, the incidence of nodal metastasis in localized prostatic cancer from surgical and histologically confirmed lymphogram series is reviewed with the concept of sensitivity and specificity of the lymphogram.
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PMID:An evaluation of lymphography with nodal biopsy in localized carcinoma of the prostate. URO-Oncology Research Group. 735 91

We have reported our observations in 72 patients with clinically localized prostatic cancer who underwent radical transpubic prostatectomy and pelvic lymphadenectomy. Of the 72 patients, histologic examination revealed that 54 had tumor confined within the capsule, three had extracapsular spread of the tumor, and 15 had nodal involvement. It is not clear whether the removal of uninvolved lymph nodes had any benefit, but it is certain that it induced no adverse effect on short-term survival. It seems that pelvic lymphadenectomy can increase the survival of those patients with minimal lymph node metastases (one to two nodes). Three patients with more extensive involvement (three to nine nodes) have survived more than three years without evidence of recurrence. The hope for the cure of prostatic cancer, however, probably lies in the development of more effective anticancer agents that destroy whatever cancer cells are not either excised by radical prostatectomy in combination with pelvic lymphadenectomy or neutralized by irradiation.
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PMID:The therapeutic role of pelvic lymphadenectomy in prostatic cancer. 745 75

In a series of 166 patients undergoing radical prostatectomy and bilateral pelvic lymph node dissection for clinical stage A and B prostate cancer we found that 83% of patients with lymph node metastases had a final tumour Gleason score > or = 7. Gleason scoring of the pre-operative biopsy demonstrated 3 groups of patients with biopsy scores < or = 5, 6, and > or = 7, and a prevalence of lymph node metastases of 2, 13 and 23% respectively. The pre-operative serum prostate specific antigen (PSA) was of marginal value in predicting either the presence of lymph node metastases or the presence of cancer, since 15% of patients with nodal metastases had normal pre-operative PSA levels, as did 54% of patients with tumour Gleason scores < or = 5. It was concluded that the need for pelvic lymph node dissection in patients with low grade tumours is questionable because of the low prevalence of lymph node metastases, and that the pre-operative biopsy can identify those patients who are at low risk for lymph node metastases.
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PMID:Re-evaluation of the need for pelvic lymphadenectomy in low grade prostate cancer. 750 92

Within a prospective protocol initiated in 1977, 100 patients with locally extensive prostate cancer (stage T3, 1982 tumor, nodes and metastasis classification) were treated by pelvic node dissection and radical prostatectomy as monotherapy. Adjuvant treatment was not given until disease progression. Radical prostatectomy, except for 3 young patients with a single micrometastasis, was not done if positive lymph nodes were found at frozen section. Six patients had positive lymph nodes at permanent sections but not at frozen section. Average followup was 43.9 months (range 1 to 155 months). Histological grade was determined according to the Mostofi system. Progression was determined biochemically (prostate specific antigen elevation) and clinically by evidence of metastatic disease, either histologically proved or evidenced as new hot spots on bone scan or chest x-rays. Of the 100 patients 41 did not undergo radical prostatectomy: 39 because of positive lymph nodes and 2 because of evidence of a stage pT4 tumor at surgical exploration. Of those 59 patients who underwent radical prostatectomy 9 had positive lymph nodes, while 2 had stage pT4, 39 stage pT3 and 9 stage pT2 tumors. Only 1 of the 9 patients with lymph node metastases is free of biochemical or clinical progression. Disease also progressed in both stage pT4, 27 of 39 stage pT3 and none of the 9 stage pT2 cases. A total of 22 patients was free of clinical or biochemical progression. Clinical progression was evidenced in approximately half of the cases as distant and local progression. Data on stage T3 disease were compared to those of 129 patients with stages T0 to T2 disease. There was a significant difference in interval to clinical progression for these 2 groups (p = 0.001). However, if grade 3 cases were excluded from the stage T3 group, this difference disappeared. Prognostic factors analyzed were pretreatment and posttreatment grade, pretreatment prostate specific antigen and prostatic acid phosphatase levels, positive margins, seminal vesicle invasion and nodal status. The analysis allows one to identify groups of patients who may benefit and others who certainly do not benefit from radical prostatectomy in this disease category. In the latter group effective adjuvant treatment is urgently indicated.
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PMID:Radical prostatectomy as a monotherapy for locally advanced (stage T3) prostate cancer. 750 23

To elucidate the outcome for patients with stage D1 (N1 to N3, M0) prostate cancer we reviewed 179 patients with lymphadenectomy proved pelvic nodal metastases who underwent immediate androgen ablation as the only initial treatment. With a median followup of 43 months, the 5 and 8-year actuarial rates of freedom from disease progression were 55% and 25%, respectively, and the median interval to disease progression was 67 months. The 5 and 8-year survival rates were 85% and 57%, respectively. Median survival after disease progression was 36 months. Local and distant disease progression was equally important. At 5 and 8 years the incidence of local progression was 32% and 51%, respectively, while metastatic rates at the same intervals wer 22% and 44%, respectively. Multivariate regression revealed that tumor grade and transurethral resection in preoperative stage C disease correlated with disease progression. Pretreatment prostate specific antigen (PSA) levels were not predictive of outcome. The fact that transurethral resection predicted for local as well as distant failure suggests that the procedure selects for rather than aggravates adverse disease. Posttreatment PSA levels were a sensitive index of response to treatment and of subsequent outcome. All patients who failed to achieve undetectable PSA levels had relapse by 8 years, whereas those whose levels became undetectable experienced only a 5% incidence of disease progression. These data show that androgen ablation alone is not curative for node positive disease but is associated with significant disease control and good short-term (5-year) survival. The primary tumor is an important source of androgen insensitive cells and comprehensive treatment strategies for this stage of disease require attention to the primary tumor as well as microscopic metastases.
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PMID:Early androgen ablation for stage D1 (N1 to N3, M0) prostate cancer: prognostic variables and outcome. 815 81

Laparoscopic pelvic lymph node dissection is increasing in popularity, in the absence of validated surgical indications. This retrospective study was performed to identify those patients who would benefit from laparoscopic pelvic lymphadenectomy. The case notes of 50 patients who underwent bilateral open pelvic lymphadenectomy with frozen section examination were reviewed. The patients were staged clinically as having A2 (16), B1 (20) and B2 (14) prostate cancer. Except for the two patients who had macroscopically involved pelvic lymph nodes at operation, all proceeded to total prostatectomy. Six patients were found to have positive pelvic nodes. Of the six, four patients were clinical stage B2, one was B1 and one was A2. The Gleason score of two of these six patients was greater than seven. The prostate specific antigen (PSA) levels correlated more with high tumour volume (i.e. grade C) rather than with D1 disease. Frozen section at the time of lymphadenectomy had a false negative rate of 2 of 6. We conclude that laparoscopic pelvic lymph node dissections (LPLND) should be performed where there is a high likelihood of nodal disease, viz. bulky tumours, poorly differentiated histology and a high PSA reading. We consider that such selective use of LPLND optimizes its diagnostic utility while minimizing its unnecessary application.
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PMID:Indications for laparoscopic pelvic lymph node dissection in the staging of prostate cancer. 753 10

A total of 28 patients with clinically localized prostate cancer have undergone laparoscopic pelvic staging lymphadenectomy. In 21% of the patients pelvic lymph node metastases were diagnosed. If the Gleason score on needle biopsy was less than 6, the likelihood of lymph node metastases was 15%, whereas 50% of patients with a Gleason score of 6 or more had lymph node spreading; Whatever cutoff was used, the preoperative PSA value unreliable to predict the regional nodal status.
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PMID:[Preoperative prediction of the presence of lymph node metastasis of prostatic carcinoma: reliability and clinical significance]. 754 67

Biological behavior of prostatic cancer is influenced by different tumor factors. The proliferative activity of the malignancies could be one of those parameters which serve as basis to design therapy and to estimate prognosis. Here ploidity and S-phase fraction of 44 prostatic cancer obtained by radical prostatectomy were compared to other known tumor characteristics (PSA, staging, grading). There are correlations between the PSA concentration, grading, staging and S phase fraction. The ploidity correlates with the grading. Neither of kinetic parameter correlated with the nodal involvement.
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PMID:[Flow cytometric examinations of patients after radical surgery for prostatic cancer]. 759 91


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