Influence of Preoperative Positive Seminal Vesicle Biopsy on the Staging of Prostatic Cancer
| Autor: | Olivier Wetzel, Denis Bretheau, Dominique Prapotnich, Joelle Bougaran, Ghislain Bochereau, Guy Vallancien |
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| Rok vydání: | 1994 |
| Předmět: |
Male
medicine.medical_specialty Biopsy Urology medicine.medical_treatment Sensitivity and Specificity Preoperative care Seminal vesicle Predictive Value of Tests Preoperative Care medicine Humans Neoplasm Invasiveness Lymph node Neoplasm Staging Prostatectomy medicine.diagnostic_test business.industry Prostatic Neoplasms Seminal Vesicles Cancer Prostate-Specific Antigen medicine.disease Prostate-specific antigen medicine.anatomical_structure Lymphatic Metastasis Predictive value of tests business |
| Zdroj: | Journal of Urology. 152:1152-1156 |
| ISSN: | 1527-3792 0022-5347 |
| DOI: | 10.1016/s0022-5347(17)32526-0 |
| Popis: | A total of 71 patients with clinically localized prostatic cancer underwent preoperative biopsy of each seminal vesicle. Group 1 (67 patients) underwent 2 seminal vesicle biopsies before lymph node dissection and vesiculo-prostatectomy, while group 2 (4 patients) underwent seminal vesicle biopsy and lymph node dissection before radiation therapy. In group 1 there were 11 positive biopsies (16.5%) with a median prostate specific antigen (PSA) level of 24 ng./ml. (range 11 to 45). Of the biopsies 56 were normal, with a median PSA level of 11.8 (range 3.5 to 88, p0.008). Histological examination of the seminal vesicles on the prostatectomy specimen revealed 18 cases of seminal vesicle invasion (sensitivity 61%, specificity 100%, positive predictive value 100% and negative predictive value 87.5%). A positive biopsy was correlated with the mean tumor volume (10.3 cc with positive biopsies versus 4.9 cc with negative biopsies) and local invasion (positive margins in 36% versus 9%, respectively, and capsular perforation in 81% versus 25%, respectively). In group 2 the 4 seminal vesicle biopsies and lymph node dissections were positive. Overall (groups 1 and 2), positive seminal vesicle biopsies were predictive of lymph node involvement in 47% of the cases versus 7% when biopsies were negative (p0.001). The postoperative course was significantly different (local recurrence and metastases in 45% versus 9%, respectively, and median interval 8.8 months versus 18.3 months, respectively, p0.001). Seminal vesicle biopsy appears to have a satisfactory yield only in cases with a PSA level of greater than 10 ng./ml. A positive seminal vesicle biopsy confirms the presence of extraprostatic invasion of clinically localized cancer in a given patient. Seminal vesicle biopsy allows for better staging of prostatic cancer. |
| Databáze: | OpenAIRE |
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