Skip to main content
Journal cover image

Comparison of clinical staging algorithms and 111indium-capromab pendetide immunoscintigraphy in the prediction of lymph node involvement in high risk prostate carcinoma patients.

Publication ,  Journal Article
Polascik, TJ; Manyak, MJ; Haseman, MK; Gurganus, RT; Rogers, B; Maguire, RT; Partin, AW
Published in: Cancer
April 1, 1999

BACKGROUND: The pretherapy prediction of occult lymph node involvement and the avoidance of otherwise futile and potentially morbid definitive local therapy is paramount in men with newly diagnosed prostate carcinoma. To identify patients with prostate carcinoma who likely have lymph node involvement and would benefit from staging lymphadenectomy prior to definitive local therapy, the authors compared the ability of several predictive staging algorithms and a radiolabeled monoclonal antibody scan to predict lymphatic metastases prior to treatment. METHODS: Between August 1991 and June 1994, 198 men with clinical T2 or T3 classified (TNM) prostate carcinoma (bone scan negative) who were at high risk of lymph node involvement underwent a 111In-capromab pendetide scan prior to staging lymphadenectomy. Several predictive models based on preoperative prostate specific antigen level, biopsy Gleason score, and clinical stage were selected to predict those men having a > or =20% probability of lymph node involvement. The ability to predict pathologic stage using several clinical algorithms and the monoclonal antibody scan was compared with pathologic examination of the lymph nodes. RESULTS: Overall, 39% of the pelvic lymph node specimens were positive for metastatic disease by pathologic analysis. Published algorithms predicting lymph node metastases had a positive predictive value (PPV) ranging from 40.5% to 46.6% and an area under the receiver operating characteristic curve (AUC) ranging from 0.52 to 0.61. The monoclonal antibody scan had a PPV of 66.7% and an AUC of 0.71. The differences between the PPV and the AUC for the individual clinical algorithms when compared with immunoscintigraphy were statistically significant. Combining the radiolabeled monoclonal antibody scan with clinical predictive models, a PPV of up to 72.1% could be obtained. CONCLUSIONS: These data suggest that the PPVs for the clinical predictive algorithms are similar and that the PPV of the radiolabeled monoclonal antibody scan alone or in combination with the algorithms has additional value in predicting lymph node involvement in prostate carcinoma patients at high risk of regional disease spread. These algorithms and the 111In-capromab pendetide scan may be used for the appropriate selection of candidates for definitive local therapy in men with clinically localized prostate carcinoma and significant risk of lymph node involvement.

Duke Scholars

Published In

Cancer

ISSN

0008-543X

Publication Date

April 1, 1999

Volume

85

Issue

7

Start / End Page

1586 / 1592

Location

United States

Related Subject Headings

  • Radioimmunodetection
  • ROC Curve
  • Prostatic Neoplasms
  • Prognosis
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Middle Aged
  • Male
  • Lymphatic Metastasis
  • Lymph Nodes
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Polascik, T. J., Manyak, M. J., Haseman, M. K., Gurganus, R. T., Rogers, B., Maguire, R. T., & Partin, A. W. (1999). Comparison of clinical staging algorithms and 111indium-capromab pendetide immunoscintigraphy in the prediction of lymph node involvement in high risk prostate carcinoma patients. Cancer, 85(7), 1586–1592.
Polascik, T. J., M. J. Manyak, M. K. Haseman, R. T. Gurganus, B. Rogers, R. T. Maguire, and A. W. Partin. “Comparison of clinical staging algorithms and 111indium-capromab pendetide immunoscintigraphy in the prediction of lymph node involvement in high risk prostate carcinoma patients.Cancer 85, no. 7 (April 1, 1999): 1586–92.
Polascik TJ, Manyak MJ, Haseman MK, Gurganus RT, Rogers B, Maguire RT, Partin AW. Comparison of clinical staging algorithms and 111indium-capromab pendetide immunoscintigraphy in the prediction of lymph node involvement in high risk prostate carcinoma patients. Cancer. 1999 Apr 1;85(7):1586–1592.
Journal cover image

Published In

Cancer

ISSN

0008-543X

Publication Date

April 1, 1999

Volume

85

Issue

7

Start / End Page

1586 / 1592

Location

United States

Related Subject Headings

  • Radioimmunodetection
  • ROC Curve
  • Prostatic Neoplasms
  • Prognosis
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Middle Aged
  • Male
  • Lymphatic Metastasis
  • Lymph Nodes