Pelvic cancers: staging of 139 cases with lymphography and fine-needle aspiration biopsy

Radiology. 1989 Oct;173(1):103-6. doi: 10.1148/radiology.173.1.2675176.

Abstract

One hundred thirty-nine patients with pelvic cancers (101 bladder carcinomas, 27 prostatic carcinomas, and 11 testicular tumors) considered for radical surgery were studied with lymphography and percutaneous fine-needle aspiration (FNA) biopsy, and the results were correlated with lymphadenectomy. Adequate material for FNA was obtained in 97%, 88%, and 100% of the bladder, prostatic, and testicular tumors, respectively. For bladder carcinoma, the global accuracy was 58% for lymphography and 93% for FNA; the high false-negative rate for lymphography (48%) was lowered to 25% with FNA, providing that the obturator nodes were punctured. For prostatic carcinomas, it was not possible to evaluate the true-positive rate because the patients with positive FNA results did not under-go surgery. For testicular tumors, lymphography and FNA had almost the same global accuracy (73% and 75%), but FNA had a better specificity (100%) than lymphography (86%). FNA had no false-positive results, which means that positive biopsy results obviate radical surgery; when FNA results are negative a lymphadenectomy should be performed. With its mild morbidity, FNA has a role in the preoperative staging of pelvic carcinomas.

MeSH terms

  • Aged
  • Biopsy, Needle*
  • Diagnostic Errors
  • Female
  • Humans
  • Lymph Node Excision
  • Lymph Nodes / pathology*
  • Lymphography*
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Pelvis
  • Predictive Value of Tests
  • Prostatic Neoplasms / diagnostic imaging
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / surgery
  • Sensitivity and Specificity
  • Testicular Neoplasms / diagnostic imaging
  • Testicular Neoplasms / pathology
  • Testicular Neoplasms / surgery
  • Urinary Bladder Neoplasms / diagnostic imaging
  • Urinary Bladder Neoplasms / pathology
  • Urinary Bladder Neoplasms / surgery
  • Urogenital Neoplasms / diagnostic imaging
  • Urogenital Neoplasms / pathology*
  • Urogenital Neoplasms / surgery