Lymphangiography and Computerized Tomography in Testicular Carcinoma: How Accurate in Early Stage Disease?

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Abstract
The usefulness of lymphangiography and computerized tomography was evaluated in 167 consecutive patients with pathologic states I and II testicular carcinoma and metastases of less than 5 cm. Lymhangiography demonstrated 74.4% sensitivity, 77.6% specificity and 76.0% over-all accuracy. Computerized tomography revealed comparable results, with 74.3% over-all accuracy, 73.7% sensitivity and75.0% specificty. The combination of lymhangiography and computerized tomography performed in 35 patients consistently improved the diagnostic possibilites of either technique alone in patients with positive nodes, reducing the false negative rate from 27-10%. This combination increased the false positive rate from 25-37% in patients with negative nodes. In patients with clinical stage I disease for whom a wait-and-see policy after orchiectomy is adopted both methods must be considered mandatory. In all other situations computerized tomography alone should be the preferred procedure in the diagnosis of retroperitoneal lymph node metastases from testicular carcinoma.