Preoperative Lymph Node Evaluation in Prostatic Cancer Patients Who are Surgical Candidates: The Role of Lymphangiography and Computerized Tomography Scanning with Directed Fine Needle Aspiration

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Abstract
A total of 53 consecutive patients who were candidates for surgical treatment of prostatic cancer underwent preoperative evaluation of the lymph node status by computerized tomography scanning and/or lymphangiography combined with skinny needle aspiration biopsy of any abnormal lymph nodes. In 7 of 14 patients (50%) ultimately found to have stage D1 disease lymphatic metastases were confirmed histologically with needle biopsy alone, thus, obviating the need for pelvic lymph node dissection. Over-all sensitivity, specificity and accuracy rates were 50%, 100% and 91.4%, respectively, for computerized tomography scanning with biopsy and 53.8%, 100% and 84.1%, respectively, for lymphangiography with biopsy. Computerized tomography scanning and lymphangiography with aspiration biopsy are cost-effective means to identify approximately 50% of the patients who ultimately have lymphatic metastases.