Prediction of lymphatic spreading in prostatic cancer by prostate-specific antigen and Gleason's score.
A total of 58 patients have undergone bilateral pelvic lymphadenectomy as a staging procedure for clinically localized adenocarcinoma of the prostate. Of these, 19 patients (33%) had pelvic lymph node involvement. When a cutoff value of 50 ng/ml was used, the preoperative prostate-specific antigen (PSA) value had a positive predictive value of 57% for pelvic lymph node metastasis. Of the patients with PSA < 20 ng/ml, only 1 (4%) had evidence of lymph node metastasis. None of the patients with well-differentiated tumor (Gleason 2-4) had lymphatic spreading. In contrast, 82% of patients with poorly differentiated tumor (Gleason 8-10) had positive pelvic lymph nodes. Those patients with high PSA (> or = 20 ng/ml) and high Gleason's score (> or = 8) had the highest incidence of nodal extension (90%).
Wu
T T
TT
Department of Surgery, Veterans General Hospital-Taipei, Taiwan, Republic of China.
Chen
K K
KK
Huang
J K
JK
Lee
Y H
YH
Chen
M T
MT
Chang
L S
LS
D000368:Aged; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000473:pathology*
D017430:Prostate-Specific Antigen