Reliability of sentinel node procedure for lymph node staging in prostate cancer patients at high risk for lymph node involvement

Figures & data

Table I. Patient and disease characteristics.

	Total (N = 74)	Patients with negative LN (N = 37)	Patients with positive LN (N = 37)
Age (median + range)	64.5 years (49.2–73.9)	65.0 years (51.8–73.2)	64.1 years (49.2–73.9)
Preoperative PSA (ng/mL) (median + range)	10.4 (1.5–70.9)	10.1 (1.5–70.9)	10.6 (5.0–25.0)
Clinical T-stage (2002 TNM)
1c	1 (1.4)	0 (0.0)	1 (2.7)
2a	2 (2.7)	1 (2.7)	1 (2.7)
2b	3 (4.1)	2 (5.4)	1 (2.7)
2c	14 (18.9)	11 (29.7)	3 (8.1)
3a	42 (56.8)	22 (59.5)	20 (54.1)
3b	11 (14.9)	1 (2.7)	10 (27.0)
4	1 (1.4)	0 (0.0)	1 (2.7)
Biopsy Gleason score
6	1 (1.4)	1 (2.7)	0 (0.0)
7 (3 + 4)	23 (31.1)	16 (43.2)	7 (18.9)
7 (4 + 3)	17 (23.0)	6 (16.2)	11 (29.7)
8	21 (28.4)	9 (24.3)	12 (32.4)
9 (4 + 5)	9 (12.2)	3 (8.1)	6 (16.2)
9 (5 + 4)	2 (2.7)	2 (5.4)	0 (0.0)
10	1 (1.4)	0 (0.0)	1 (2.7)
Pathologic T-stage (2002 TNM)
2b	2 (2.7)	2 (5.4)	0 (0.0)
2c	30 (40.5)	23 (62.2)	7 (18.9)
3a	20 (27.0)	10 (27.0)	10 (27.0)
3b	19 (25.7)	0 (0.0)	19 (51.4)
4	3 (4.1)	2 (5.4)	1 (2.7)
Pathologic Gleason score
7 (3 + 4)	17 (23.0)	14 (37.8)	3 (8.1)
7 (4 + 3)	25 (33.8)	16 (43.2)	9 (24.3)
8	14 (18.9)	2 (5.4)	12 (32.4)
9 (4 + 5)	15 (20.3)	4 (10.8)	11 (29.7)
9 (5 + 4)	2 (2.7)	1 (2.7)	1 (2.7)
10	1 (1.4)	0 (0.0)	1 (2.7)
Tumor volume (median + range)
Relative (%)	7.2 (0.4–37.0)	6.6 (0.4–19.4)	9.2 (0.9–37.0)
Absolute (ml)	3.4 (0.3–24.0)	2.6 (0.3–10.7)	4.2 (0.9–24.0)
Nodes examined per patient (median + range)	21 (7–49)	21 (7–42)	21 (10–49)

LN, lymph node; PSA, prostate-specific antigen. Numbers between parentheses are percentages unless indicated otherwise.

Table II. Localization of SN that were scintigraphically detected and surgically retrieved and the number of (affected) LN removed (SN + seLND) when completing the SN procedure with a seLND.

		Total	Obturator region	External iliac region	Internal iliac region	Presacral region	Common iliac region	Others
SN scintigraphically detected	N nodes (%)	470 (100)	78 (17)	77 (16)	107 (23)	35 (7)	88 (19)	85 (18)
	Median (IQR)	6 (3–9)	1 (0–2)	1 (0–2)	1 (1–2)	0 (0–1)	1 (0–2)	1 (0–2)
SN removed	N nodes (%)	371 (100)	94 (25)	71 (19)	91 (25)	49 (13)	53 (14)	13 (4)
	Median (IQR)	4 (2.25–6)	1 (0–2)	1 (0–1.75)	1 (0–2)	0 (0–1)	0 (0–1)	0 (0–0)
	N+ (%)	50 (100)	13 (26)	12 (24)	19 (38)	4 (8.0)	1 (2)	1 (2)
LN dissection	N nodes (%)	1658 (100)	506 (31)	435 (26)	298 (18)	162 (10)	237 (14)	20 (1)
	Median (IQR)	21 (16–27)	6 (4–9)	5 (4–8)	3 (2–5)	2 (1–3)	3 (2–4)	0 (0–0)
	N+ (%)	106 (100)	26 (25)	30 (28)	35 (33)	9 (8)	5 (5)	1 (1)

LN, lymph nodes; SN, sentinel node; N+, affected lymph node(s), Others: paraaortic, aortic bifurcation, pararectal, paravesical, mesenteric fat and/or inguinal region.

Figure 1. Schematic overview of the results of a SN procedure and consecutive seLND for 74 patients at high risk for LN involvement. LNI, lymph node involvement; N-, node-negative; N+, node-positive; seLND, superextended lymph node dissection; SN, sentinel node. *details see Supplementary Table I.