Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 10/2016

01-09-2016 | Original Article

Laparoscopic sentinel lymph node dissection in prostate cancer patients: the additional value depends on preoperative data

Authors: Caroline Rousseau, Thierry Rousseau, Cédric Mathieu, Jacques Lacoste, Eric Potiron, Geneviève Aillet, Pierre Nevoux, Georges Le Coguic, Loïc Campion, Françoise Kraeber-Bodéré

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 10/2016

Login to get access

Abstract

Aim

In intermediate- or high-risk prostate cancer (PC) patients, to avoid extended pelvic lymph node dissection (ePLND), the updated Briganti nomogram is recommended with the cost of missing 1.5 % of patients with lymph node invasion (LNI). Is it possible to reduce the percentage of unexpected LNI patients (nomogram false negative)? We used the isotopic sentinel lymph node (SLN) technique systematically associated with laparoscopic ePLND to assess the potential value of isotopic SLN method to adress this point.

Methods

Two hundred and two consecutive patients had procedures with isotopic SLN detection associated with laparoscopic ePLND for high or intermediate risk of PC. The area under the curve (AUC) of the receiver operating characteristics (ROC) analysis was used to quantify the accuracy of different models as: the updated Briganti nomogram, the percentage of positive cores, and an equation of the best predictors of LNI. We tested the model cutoffs associated with an optimal negative predictive value (NPV) and the best cutoff associated with avoiding false negative SLN detection, in order to assist the clinician’s decision of when to spare ePLND.

Results

LNI was detected in 35 patients (17.2 %). Based on preoperative primary Gleason grade and percentage of positive cores, a bivariate model was built to calculate a combined score reflecting the risk of LNI. For the Briganti nomogram, the 5 % probability cutoff avoided ePLND in 53 % (108/202) of patients, missing three LNI patients (8.6 %), but all were detected by the SLN technique. For our bivariate model, the best cutoff was <10, leaving no patient with LNI due to positive SLN detection (four patients = 11.4 %), and avoiding ePLND in 52 % (105/202) of patients.

Conclusion

For patients with a low risk of LNI determined using the updated Briganti nomogram or bivariate model, SLN technique could be used alone for lymph node staging in intermediate- or high-risk PC patients.
Literature
1.
Bubendorf L, Schöpfer A, Wagner U, Sauter G, Moch H, Willi N, et al. Metastatic patterns of prostate cancer: an autopsy study of 1,589 patients. Hum Pathol. 2000;31:578–83.CrossRefPubMed
2.
Cheng L, Zincke H, Blute M, Bergstralh E, Scherer B, Bostwick D. Risk of prostate carcinoma death in patients with lymph node metastasis. Am Cancer Soc. 2001;91:66–73.
3.
Heidenreich A, Aus G, Bolla M, Joniau S, Matveer VB, Schmid HP, et al. EAU guidelines on prostate cancer. Eur Urol. 2008;53:68–80.CrossRefPubMed
4.
Briganti A, Chun FK-H, Salonia A, Suardi N, Gallina A, Da Pozzo LF, et al. Complications and other surgical outcomes associated with extended pelvic lymphadenectomy in men with localized prostate cancer. Eur Urol. 2006;50:1006–13.CrossRefPubMed
5.
Van Baelen A, Mottet N, Spahn M, Briganti A, Gontero P, Joniau S. Sense and nonsense of an extended pelvic lymph node dissection in prostate cancer. Adv Urol. 2012;2012:983058.PubMed
6.
Briganti A, Capitanio U, Abdollah F, Gallina A, Suardi N, Bianchi M, et al. Assessing the risk of lymph node invasion in patients with intermediate risk prostate cancer treated with extended pelvic lymph node dissection. A novel prediction tool. Prostate. 2012;72(5):499–506.CrossRefPubMed
7.
Briganti A, Suardi N, Gallina A, Abdollah F, Montorsi F. Pelvic lymph node dissection in prostate cancer: the mystery is taking shape. Eur Urol. 2013;63(3):459–61.CrossRefPubMed
8.
Heidenreich A, Bastian PJ, Bellmunt J, Bolla M, Joniau S, van der Kwast T, et al. EAU guidelines on prostate cancer. part 1: screening, diagnosis, and local treatment with curative intent-update 2013. Eur Urol. 2014;65(1):124–37.CrossRefPubMed
9.
Briganti A, Larcher A, Abdollah F, Capitanio U, Gallina A, Suardi N, et al. Updated nomogram predicting lymph node invasion in patients with prostate cancer undergoing extended pelvic lymph node dissection: the essential importance of percentage of positive cores. Eur Urol. 2012;61(3):480–7.CrossRefPubMed
10.
Acar C, Kleinjan GH, van den Berg NS, Wit EM, van Leeuwen FW, van der Poel HG. Advances in sentinel node dissection in prostate cancer from a technical perspective. Int J Urol. 2015;22(10):898–909.CrossRefPubMed
11.
Winter A, Kneib T, Henke RP, Wawroschek F. Sentinel lymph node dissection in more than 1200 prostate cancer cases: rate and prediction of lymph node involvement depending on preoperative tumor characteristics. Int J Urol. 2013;21(1):58–63.CrossRefPubMed
12.
Rousseau C, Rousseau T, Campion L, Lacoste J, Aillet G, Potiron E, et al. Laparoscopic sentinel lymph node versus hyperextensive pelvic dissection for staging clinically localized prostate carcinoma: a prospective study of 200 patients. J Nucl Med. 2014;55(5):753–8.CrossRefPubMed
13.
D’Amico AV, Whittington R, Malkowicz SB, Tomaszewski JE, Schultz D, Wein A. Outcome based staging for clinically localizedadenocarcinomaof the prostate. J Urol. 1997;158:1422–6.CrossRefPubMed
14.
Rousseau T, Lacoste J, Pallardy A, Campion L, Bridji B, Mouaden A, et al. Laparoscopic sentinel lymph node (SLN) dissection for clinically localized prostate carcinoma: results obtained in the first 70 patients. Prog Urol. 2011;22:30–7.CrossRefPubMed
15.
Rousseau C, Rousseau T, Bridji B, et al. Laparoscopic sentinel lymph node (SLN) versus extensive pelvic dissection for clinically localized prostate carcinoma. Eur J Nucl Med Mol Imaging. 2012;39(2):291–9.CrossRefPubMed
16.
Fujisawa M, Miyake H. Significance of micrometastases in prostate cancer. Surg Oncol. 2008;17:247–52.CrossRefPubMed
17.
Chéreau E, Bezu C, Gligorov J, Sakr R, Antoine M, Daraï E, et al. Impact of immunohistochemical analysis of sentinel lymph node biopsy on breast cancer management. Anticancer Res. 2012;32:3403–9.PubMed
18.
Hansen J, Rink M, Bianchi M, Kluth LA, Tian Z, Ahyai SA, et al. External validation of the updated Briganti nomogram to predict lymph node invasion in prostate cancer patients undergoing extended lymph node dissection. Prostate. 2013;73(2):211–8.CrossRefPubMed
19.
Gacci M, Schiavina R, Lanciotti M, Masieri L, Serni S, Vagnoni V, et al. External validation of the updated nomogram predicting lymph node invasion in patients with prostate cancer undergoing extended pelvic lymph node dissection. Urol Int. 2013;90(3):277–82.CrossRefPubMed
20.
Dell’Oglio P, Abdollah F, Suardi N, Gallina A, Cucchiara V, Vizziello D, et al. External validation of the European association of urology recommendations for pelvic lymph node dissection in patients treated with robot-assisted radical prostatectomy. J Endourol. 2014;28(4):416–23.CrossRefPubMed
Metadata
Title
Laparoscopic sentinel lymph node dissection in prostate cancer patients: the additional value depends on preoperative data
Authors
Caroline Rousseau
Thierry Rousseau
Cédric Mathieu
Jacques Lacoste
Eric Potiron
Geneviève Aillet
Pierre Nevoux
Georges Le Coguic
Loïc Campion
Françoise Kraeber-Bodéré
Publication date
01-09-2016
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 10/2016
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-016-3397-2

Other articles of this Issue 10/2016

European Journal of Nuclear Medicine and Molecular Imaging 10/2016 Go to the issue

Review Article

Radium-223 dichloride in clinical practice: a review

Original Article

Dual time-point FDG PET/CT and FDG uptake and related enzymes in lymphadenopathies: preliminary results

Original Article

Monitoring metabolic response using FDG PET-CT during targeted therapy for metastatic colorectal cancer

Original Article

Diagnostic accuracy of FDG PET/CT for clinical evaluation at the end of treatment of HL and NHL: a comparison of the Deauville Criteria (DC) and the International Harmonization Project Criteria (IHPC)

Original Article

Ruptured human Achilles tendon has elevated metabolic activity up to 1 year after repair

Image of the Month

18F-Labelled PSMA-1007 shows similarity in structure, biodistribution and tumour uptake to the theragnostic compound PSMA-617