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Prediction of Micrometastasis (< 1 cm) to Pelvic Lymph Nodes in Prostate Cancer: Role of Preoperative MRI

Authors
 Sung Yoon Park  ;  Young Taik Oh  ;  Dae Chul Jung  ;  Nam Hoon Cho  ;  Young Deuk Choi  ;  Koon Ho Rha 
Citation
 AMERICAN JOURNAL OF ROENTGENOLOGY, Vol.205(3) : 328-334, 2015 
Journal Title
 AMERICAN JOURNAL OF ROENTGENOLOGY 
ISSN
 0361-803X 
Issue Date
2015
MeSH
Aged ; Humans ; Lymph Node Excision ; Lymphatic Metastasis/pathology* ; Magnetic Resonance Imaging* ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Micrometastasis/pathology* ; Neoplasm Staging ; Pelvis ; Predictive Value of Tests ; Preoperative Care ; Prostate-Specific Antigen/blood ; Prostatectomy ; Prostatic Neoplasms/blood ; Prostatic Neoplasms/pathology* ; Prostatic Neoplasms/surgery ; ROC Curve ; Retrospective Studies
Keywords
MRI ; lymph node metastasis ; micrometastasis ; prostate cancer ; tumor staging
Abstract
OBJECTIVE: The purpose of this study was to retrospectively investigate whether preoperative MRI plays a key role in clinical prediction of micrometastasis (< 1 cm) to pelvic lymph nodes in prostate cancer. MATERIALS AND METHODS: One hundred one patients with prostate cancer who underwent preoperative MRI and radical prostatectomy with pelvic lymph node dissection were included. None of the patients had a pelvic lymph node with a short-axis diameter of 1 cm or larger on MRI. Both clinical (prostate-specific antigen, biopsy Gleason score, greatest percentage of biopsy core, and percentage of positive cores) and MRI parameters (tumor apparent diffusion coefficient and tumor staging) were assessed. The univariate, multivariate, and ROC curve analyses were conducted. RESULTS: Of 101 patients, nine (8.9%) had pelvic lymph node metastases. In univariate analysis, all of the clinical and MRI parameters were related to micrometastasis to pelvic lymph nodes (p < 0.05). However, multivariate analysis revealed that only preoperative MRI stage was significant (p = 0.044). AUC of preoperative MRI stage was 0.954 (odds ratio, 21.7). Respective sensitivity and specificity of preoperative tumor staging by MRI were 100% and 65.2% with cutoff of T3a or more, and 88.9% and 94.6% with cutoff of T3b for predicting micrometastasis to pelvic lymph nodes. CONCLUSION: Preoperative MRI staging may play a role in prediction of micrometastasis (< 1 cm) to pelvic lymph nodes in prostate cancer.
Full Text
http://www.ajronline.org/doi/abs/10.2214/AJR.14.14138
DOI
10.2214/AJR.14.14138
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Park, Sung Yoon(박성윤)
Oh, Young Taik(오영택) ORCID logo https://orcid.org/0000-0002-4438-8890
Jung, Dae Chul(정대철) ORCID logo https://orcid.org/0000-0001-5769-5083
Cho, Nam Hoon(조남훈) ORCID logo https://orcid.org/0000-0002-0045-6441
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/141193
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