RESUMEN
OBJECTIVE: To determine the correlation between PSA values and the histopathological findings of ileo-obturator node dissection in prostatic cancer. METHODS: We reviewed the data of 51 patients with clinically localized prostatic carcinoma, submitted to ileo-obturator node dissection before definitive treatment of the tumor. The patients were classified into 4 groups according to their previous PSA values: A < 10 ng/ml, B > 10 and < 20 ng/ml, C > 20 and < 50 ng/ml and D < 50 ng/ml. RESULTS: Overall 17.6% of the patients had positive lymph nodes; 9.9% of the patients in group A, 15.4% of the patients in group B, 11.1% of those in group C and 41.7% of those in group D had positive nodes. Using 50 ng/ml as the cut-off point, 10% of those with PSA < 50 ng/ml had positive nodes vs 42.3% of those with PSA > 50 ng/ml, which was statistically significant with the Fischer test. CONCLUSION: Preoperative PSA has a statistically significant correlation with positive nodes, considering 50 ng/ml as the cut-off point. PSA determination in patients that have received no treatment is essential in the diagnosis and evaluation of therapy in prostate cancer.
Asunto(s)
Adenocarcinoma/sangre , Adenocarcinoma/patología , Antígeno Prostático Específico/sangre , Neoplasias de la Próstata/sangre , Neoplasias de la Próstata/patología , Anciano , Anciano de 80 o más Años , Humanos , Escisión del Ganglio Linfático/métodos , Metástasis Linfática , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
OBJECTIVES: To analyze the correlation between PSA values, bony symptoms and total body bone scintiscanning in order to determine the utility of the latter technique in patients with adenocarcinoma of the prostate. METHODS: We analyzed the correlation between the PSA values, bony symptoms and total body bone scintiscan findings of 191 patients with adenocarcinoma of the prostate; of these, 129 patients met the criteria for inclusion into the study. RESULTS: Of the 128 patients, 32 (25%) had PSA value < 20 ng/ml, 48 (37.5%) had values ranging from 20-50 ng/ml and 48 (37.5%) had values > 50 ng/ml. The bone scintiscan was positive in only one of the 32 patients with PSA < 20 ng/ml, 45.8% of those with PSA values between 20-50 ng/ml and 70.8% of those with PSA values > 50 ng/ml. All of the patients with PSA < 20 ng/ml and no bony symptoms had a negative bone scintiscan. All patients with PSA > 20 ng/ml and bony symptoms had a positive bone scintiscan. CONCLUSIONS: PSA is a biological marker that can effectively predict the scintiscan findings. The bone scintiscan was negative in 96.9% of the patients with PSA < 20 ng/ml. Total body bone scintiscanning can therefore be obviated in patients with PSA < 20 ng/ml and no bony symptoms, thereby reducing health costs without altering the benefits.
Asunto(s)
Adenocarcinoma/sangre , Adenocarcinoma/secundario , Neoplasias Óseas/diagnóstico por imagen , Neoplasias Óseas/secundario , Antígeno Prostático Específico/sangre , Neoplasias de la Próstata/sangre , Anciano , Anciano de 80 o más Años , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de la Próstata/patología , CintigrafíaRESUMEN
OBJECTIVES: We evaluated the management of the regional lymph nodes to determine the appropriate treatment for carcinoma of the penis. METHODS: The records of 36 patients with carcinoma of the penis were reviewed. Lymphadenectomy was performed in 18 patients, 17 were managed conservatively (watchful waiting) and 1 patient had a biopsy and received radiotherapy. RESULTS: Positive nodes were found in 2 of 2 pT4, 2 of 3 pT3, 8 of 13 pT2 and 2 of 12 pT1 patients submitted to lymphadenectomy. Concerning the histological grade, positive nodes were found in all of the 4 G3, 5 of 12 G2 and 3 of 20 G1 patients. The survival rate was 100% for the patients with negative lymph nodes (pNO = 6) or a single positive inguinal lymph node (pN1 = 5). A correlation was found between the T and the histological grade and the likelihood of lymph node invasion. CONCLUSIONS: The T and the histological grade of the primary lesion must be considered when deciding the approach in the management of the lymph nodes as unnecessary lymphadenectomy can be avoided and those at high risk of lymph node invasion can be treated radically and timely.