OBJECTIVES: To map the primary prostatic lymphatic landing sites using a multimodality technique. METHODS: Thirty-four patients with organ-confined prostate cancer (cT1-cT2; cN0) underwent single-photon emission computed tomography fused with data from computed tomography (SPECT/CT) (n=33) or magnetic resonance imaging (SPECT/MRI) (n=1) 1h after ultrasound-guided intraprostatic injection of technecium (Tc-99m) nanocolloid. The presence of lymph nodes (LNs) containing Tc-99m was confirmed intraoperatively with a gamma probe. A backup extended pelvic lymphadenectomy (PLND) was performed to preclude missed primary lymphatic landing sites. The SPECT/CT/MRI data sets were used to generate a three-dimensional projection of each LN site. RESULTS: A total of 317 LNs (median, 10 per patient; range, 3-19) were detected by SPECT/CT/MRI, 314 of which were confirmed by gamma probe. With an "extended" PLND, two thirds of all primary prostatic lymphatic landing sites are resected compared with only one third with a "limited" PLND. CONCLUSIONS: The multimodality technique presented here enables precise mapping of the primary prostatic lymphatic landing sites. PLND for prostate cancer should include not only the external and obturator regions as well as the portions medial and lateral to the internal iliac vessels, but also the common iliac LNs at least up to the ureteric crossing, thus removing approximately 75% of all nodes potentially harbouring metastasis.
OBJECTIVES: To map the primary prostatic lymphatic landing sites using a multimodality technique. METHODS: Thirty-four patients with organ-confined prostate cancer (cT1-cT2; cN0) underwent single-photon emission computed tomography fused with data from computed tomography (SPECT/CT) (n=33) or magnetic resonance imaging (SPECT/MRI) (n=1) 1h after ultrasound-guided intraprostatic injection of technecium (Tc-99m) nanocolloid. The presence of lymph nodes (LNs) containing Tc-99m was confirmed intraoperatively with a gamma probe. A backup extended pelvic lymphadenectomy (PLND) was performed to preclude missed primary lymphatic landing sites. The SPECT/CT/MRI data sets were used to generate a three-dimensional projection of each LN site. RESULTS: A total of 317 LNs (median, 10 per patient; range, 3-19) were detected by SPECT/CT/MRI, 314 of which were confirmed by gamma probe. With an "extended" PLND, two thirds of all primary prostatic lymphatic landing sites are resected compared with only one third with a "limited" PLND. CONCLUSIONS: The multimodality technique presented here enables precise mapping of the primary prostatic lymphatic landing sites. PLND for prostate cancer should include not only the external and obturator regions as well as the portions medial and lateral to the internal iliac vessels, but also the common iliac LNs at least up to the ureteric crossing, thus removing approximately 75% of all nodes potentially harbouring metastasis.
Authors: Sean P Stroup; Christopher J Kane; Salman Farchshchi-Heydari; Claude M James; Christopher H Davis; Anne M Wallace; Carl K Hoh; David R Vera Journal: Clin Exp Metastasis Date: 2012-06-20 Impact factor: 5.150
Authors: Alessandro Conti; Matteo Santoni; Luciano Burattini; Marina Scarpelli; Roberta Mazzucchelli; Andrea B Galosi; Liang Cheng; Antonio Lopez-Beltran; Alberto Briganti; Francesco Montorsi; Rodolfo Montironi Journal: World J Urol Date: 2015-12-22 Impact factor: 4.226
Authors: Michal Staník; Ivo Čapák; Daniel Macík; Jiří Vašina; Eva Lžičařová; Jiří Jarkovský; Martin Šustr; David Miklánek; Jan Doležel Journal: Int Urol Nephrol Date: 2014-03-29 Impact factor: 2.370
Authors: C M de Korne; E M Wit; J de Jong; R A Valdés Olmos; T Buckle; F W B van Leeuwen; H G van der Poel Journal: Eur J Nucl Med Mol Imaging Date: 2019-08-03 Impact factor: 9.236
Authors: Daniel E Spratt; Hebert A Vargas; Zachary S Zumsteg; Jennifer S Golia Pernicka; Joseph R Osborne; Xin Pei; Michael J Zelefsky Journal: Eur Urol Date: 2016-08-11 Impact factor: 20.096