MP62-12 PREDICTIVE ABILITY OF PREBIOPSY MULTIPARAMETRIC MAGNETIC RESONANCE IMAGING FOR NEGATIVE LYMPH NODE METASTASIS OF THE SIDE IN RADICAL PROSTATECTOMY: FEASIBILITY OF UNILATERAL LYMPH NODE DISSECTION

Abstract

You have accessJournal of UrologyProstate Cancer: Staging I (MP62)1 Apr 2020MP62-12 PREDICTIVE ABILITY OF PREBIOPSY MULTIPARAMETRIC MAGNETIC RESONANCE IMAGING FOR NEGATIVE LYMPH NODE METASTASIS OF THE SIDE IN RADICAL PROSTATECTOMY: FEASIBILITY OF UNILATERAL LYMPH NODE DISSECTION Noboru Numao*, Yudai Ishikawa, Shinya Yamamoto, Motohiro Fujiwara, Shotaro Yasuoka, Ryo Fujiwara, Yoshinobu Komai, Takeshi Yuasa, Iwao Fukui, and Junji Yonese Noboru Numao*Noboru Numao* More articles by this author , Yudai IshikawaYudai Ishikawa More articles by this author , Shinya YamamotoShinya Yamamoto More articles by this author , Motohiro FujiwaraMotohiro Fujiwara More articles by this author , Shotaro YasuokaShotaro Yasuoka More articles by this author , Ryo FujiwaraRyo Fujiwara More articles by this author , Yoshinobu KomaiYoshinobu Komai More articles by this author , Takeshi YuasaTakeshi Yuasa More articles by this author , Iwao FukuiIwao Fukui More articles by this author , and Junji YoneseJunji Yonese More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000937.012AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Localization of cancer lesion in the prostate is reported to be associated with difference between right and left in frequency of lymph node metastasis (LNM). However, preoperatively it is difficult to evaluate detailed cancer lesions in the prostate. Therefore, pelvic lymph node dissection (PLND) is recommended to perform bilaterally in radical prostatectomy (RP). Previous studies have demonstrated that side-specific negative biopsy cannot predict negative LNM of the side in patients undergoing PLND in RP. In this study, we investigated whether prebiopsy multiparametric magnetic resonance imaging (mpMRI) findings can predict negative LNM of the side to explore feasibility of unilateral PLND in RP. METHODS: A total of 1980 prostate cancer patients underwent RP in our institution Between January 2005 and August 2018. Of these, we selected 344 patients who underwent prebiopsy mpMRI, a combination of mpMRI-targeted biopsy and the median 14-core systematic biopsy, and RP with extended PLND without neoadjuvant hormonal treatment. We defined extended PLND as fulfilling the following criteria: 1) 10 or more dissected lymph nodes; 2) dissection of the nodes overlying the external iliac artery and vein, the nodes within the obturator fossa located cranially and caudally to the obturator nerve, and the nodes medial and lateral to the internal iliac artery in principle. PLND area was somewhat modified by each surgeon. MRI, biopsy findings and LNM were assessed for each side. The negative predictive value (NPV) of biopsy and MRI for ipsilateral LNM was examined. RESULTS: LNM were found in 6.4% of all patients. The rate of LNM according to risk category was 0%(0/8), 3.8%(8/208) and 11%(14/128) in low, intermediate, high risk, respectively. Number of side with biopsy-positive/mpMRI-positive, biopsy-positive/mpMRI-negative, biopsy-negative/mpMRI-positive and biopsy-negative/mpMRI-negative were 340, 176, 21 and 151, respectively. In side-specific analysis, the NPV of biopsy and mpMRI 98.8 and 98.6 for ipsilateral LNM, respectively. The positive predictive value of biopsy, mpMRI was 5.8 and 6.4 for ipsilateral LNM, respectively. CONCLUSIONS: Prebiopsy mpMRI and subsequent biopsy based on mpMRI was useful for prediction of side-specific negative LNM in RP. Our findings suggest feasibility of unilateral PLND according to side-specific risk of LNM using prebiopsy mpMRI. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e950-e950 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Noboru Numao* More articles by this author Yudai Ishikawa More articles by this author Shinya Yamamoto More articles by this author Motohiro Fujiwara More articles by this author Shotaro Yasuoka More articles by this author Ryo Fujiwara More articles by this author Yoshinobu Komai More articles by this author Takeshi Yuasa More articles by this author Iwao Fukui More articles by this author Junji Yonese More articles by this author Expand All Advertisement PDF downloadLoading ...