Magnetometer-Guided Sentinel Lymph Node Dissection in Prostate Cancer: Rate of Lymph Node Involvement Compared with Radioisotope Marking
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Patient Populations
2.2. sPLND Technique and Histopathological Examination
2.3. Data Analyses
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
Method | Magnetometer-Guided sPLND | Radioisotope-Guided sPLND | ||||
---|---|---|---|---|---|---|
Overall | pN0 | pN1 | Overall | pN0 | pN1 | |
n (%) | 847 * | 655 (77.33) | 192 (22.67) | 847 | 627 (74.03) | 220 (25.97) |
Age (IQR) | 67 (62–71) | 67 (61–71) | 68 (64–73) | 67 (62–71) | 67 (62–71) | 68 (63–72) |
Total PSA ng/mL (IQR) | 8.7 (6.1–13.4) | 8.0 (5.8–11.8) | 12.7 (8.6–27.3) | 8.6 (6.0–14.3) | 7.8 (5.6–12.4) | 12.2 (8.1–20.2) |
Dissected LNs (IQR) | 14 (10–18) | 13 (10–17) | 16 (12–20) | 10 (8–14) | 10 (7–13) | 12 (9–15) |
Positive LNs (IQR) | 0 (-) | 0 (-) | 2 (1–4) | 0 (0–1) | 0 (-) | 2 (1–3) |
Dissected SLNs (IQR) | 7 (4–10) | 7 (5–10) | 6 (4–10) | 5 (3–7) | 5 (3–7) | 5 (3–8) |
Positive SLNs (IQR) | 0 (-) | 0 (-) | 1 (1–2) | 0 (-) | 0 (-) | 1 (1–2) |
Clinical tumor stage (%) | ||||||
cT1 | 436 (51.48) | 397 (60.61) | 39 (20.31) | 464 (54.78) | 401 (63.96) | 63 (28.64) |
cT2 | 368 (43.45) | 244 (37.25) | 124 (64.58) | 357 (42.15) | 222 (35.41) | 135 (61.36) |
cT3 | 41 (4.84) | 14 (2.14) | 27 (14.06) | 24 (2.83) | 4 (0.64) | 20 (9.09) |
cT4 | 2 (0.24) | 0 | 2 (1.04) | 2 (0.24) | 0 | 2 (0.91) |
Biopsy Gleason sum (%) | ||||||
≤6 | 162 (19.13) | 150 (22.90) | 12 (6.25) | 162 (19.13) | 153 (24.40) | 9 (4.09) |
=7 (3 + 4) | 401 (47.34) | 354 (54.05) | 47 (24.48) | 422 (49.82) | 349 (55.66) | 73 (33.18) |
=7 (4 + 3) | 129 (15.23) | 88 (13.44) | 41 (21.35) | 115 (13.58) | 64 (10.21) | 51 (23.18) |
≥8 | 155 (18.30) | 63 (9.62) | 92 (47.92) | 148 (17.47) | 61 (9.73) | 87 (39.55) |
Postoperative Gleason sum (%) | ||||||
≤6 | 30 (3.54) | 30 (4.58) | 0 | 58 (6.85) | 58 (9.25) | 0 |
=7 (3 + 4) | 443 (52.30) | 423 (64.58) | 20 (10.42) | 438 (51.71) | 406 (64.75) | 32 (14.55) |
=7 (4 + 3) | 215 (25.38) | 147 (22.44) | 68 (35.42) | 204 (24.09) | 111 (17.7) | 93 (42.27) |
≥8 | 159 (18.77) | 55 (8.4) | 104 (54.17) | 147 (17.36) | 52 (8.29) | 95 (43.18) |
Pathologic tumor stage (%) | ||||||
pT1c | 2 (0.24) | 2 (0.31) | 0 | 1 (0.12) | 1 (0.16) | 0 |
pT2a | 41 (4.84) | 41 (6.26) | 0 | 64 (7.56) | 61 (9.73) | 3 (1.36) |
pT2b | 21 (2.48) | 19 (2.90) | 2 (1.04) | 8 (0.94) | 8 (1.28) | 0 |
pT2c | 399 (47.11) | 390 (59.54) | 9 (4.69) | 378 (44.63) | 362 (57.74) | 16 (7.27) |
pT3a | 177 (20.90) | 141 (21.53) | 36 (18.75) | 180 (21.25) | 127 (20.26) | 53 (24.09) |
pT3b | 197 (23.26) | 61 (9.31) | 136 (70.83) | 188 (22.20) | 62 (9.89) | 126 (57.27) |
pT4 | 10 (1.18) | 1 (0.15) | 9 (4.69) | 28 (3.31) | 6 (0.96) | 22 (10) |
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Method | Magnetometer-Guided sPLND | Radioisotope-Guided sPLND | ||||
---|---|---|---|---|---|---|
Overall | pN0 | pN1 | Overall | pN0 | pN1 | |
n (%) | 848 | 655 (77.24) | 193 (22.76) | 2092 | 1696 (81.07) | 396 (18.93) |
Age (IQR) | 67 (62–71) | 67 (61–71) | 68 (64–73) | 67 (62–71) | 67 (61–71) | 68 (63–71) |
Total PSA ng/mL (IQR) | 8.7 (6.1–13.5) | 8 (5.8–11.8) | 12.8 (8.6–27.7) | 7.8 (5.5–12.5) | 7.2 (5.3–10.9) | 12.0 (7.9–20.6) |
Dissected LNs (IQR) | 14 (10–18) | 13 (10–17) | 16 (12–21) | 10 (7–14) | 10 (7–13) | 12 (9–15) |
Positive LNs (IQR) | 0 (-) | 0 (-) | 2 (1–4) | 0 (-) | 0 (-) | 2 (1–3) |
Dissected SLNs (IQR) | 7 (4–10) | 7 (5–10) | 6 (4–10) | 6 (4–8) | 6 (4–8) | 6 (3–8) |
Positive SLNs (IQR) | 0 (-) | 0 (-) | 1 (1–2) | 0 (-) | 0 (-) | 1 (1–2) |
Clinical tumor stage (%) | * | * | ** | ** | ** | |
cT1 | 436 (51.42) | 397 (60.61) | 39 (20.21) | 1129 (53.97) | 1027 (60.55) | 102 (25.76) |
cT2 | 368 (43.40) | 244 (37.25) | 124 (64.25) | 919 (43.93) | 658 (38.80) | 261 (65.91) |
cT3 | 41 (4.83) | 14 (2.14) | 27 (13.99) | 36 (1.72) | 6 (0.35) | 30 (7.58) |
cT4 | 2 (0.24) | 0 | 2 (1.04) | 2 (0.10) | 0 | 2 (0.51) |
Biopsy Gleason sum (%) | *** | *** | ||||
≤6 | 162 (19.10) | 150 (22.90) | 12 (6.22) | 998 (47.71) | 938 (55.31) | 60 (15.15) |
=7 (3 + 4) | 402 (47.41) | 354 (54.05) | 48 (24.87) | 724 (34.61) | 570 (33.61) | 154 (38.89) |
=7 (4 + 3) | 129 (15.21) | 88 (13.44) | 41 (21.24) | 191 (9.13) | 109 (6.43) | 82 (20.71) |
≥8 | 155 (18.28) | 63 (9.62) | 92 (47.67) | 176 (8.41) | 76 (4.48) | 100 (25.25) |
Postoperative Gleason sum (%) | ||||||
≤6 | 30 (3.54) | 30 (4.58) | 0 | 349 (16.68) | 348 (20.52) | 1 (0.25) |
=7 (3 + 4) | 443 (52.24) | 423 (64.58) | 20 (10.36) | 1122 (53.63) | 1052 (62.03) | 70 (17.68) |
=7 (4 + 3) | 216 (25.47) | 147 (22.44) | 69 (35.75) | 420 (20.08) | 230 (13.56) | 190 (47.98) |
≥8 | 159 (18.75) | 55 (8.40) | 104 (53.89) | 201 (9.61) | 66 (3.89) | 135 (34.09) |
Pathologic tumor stage (%) | ||||||
pT1c | 2 (0.24) | 2 (0.31) | 0 | 1 (0.05) | 1 (0.06) | 0 |
pT2a | 41 (4.83) | 41 (6.26) | 0 | 184 (8.80) | 180 (10.61) | 4 (1.01) |
pT2b | 21 (2.48) | 19 (2.90) | 2 (1.04) | 40 (1.91) | 39 (2.30) | 1 (0.25) |
pT2c | 399 (47.05) | 390 (59.54) | 9 (4.66) | 1086 (51.91) | 1048 (61.79) | 38 (9.60) |
pT3a | 178 (20.99) | 141 (21.53) | 37 (19.17) | 407 (19.46) | 300 (17.69) | 107 (27.02) |
pT3b | 197 (23.23) | 61 (9.31) | 136 (70.47) | 318 (15.20) | 113 (6.66) | 205 (51.77) |
pT4 | 10 (1.18) | 1 (0.15) | 9 (4.66) | 56 (2.68) | 15 (0.88) | 41 (10.35) |
Comparison | Original Results | Test Statistic | Adjusted Results | Test Statistic |
---|---|---|---|---|
SLN detection rate | 98.11% (832) vs. 98.18% (2054) | χ2 < 0.001, df = 1, p = 1 | 98.11% (832) vs. 95.87% (812) | χ2 = 6.55, df = 1, p = 0.011 * |
Number of dissected SLNs | 7 (4–10) vs. 6 (4–8) | W = 1,059,411, p < 0.001 *** | 7 (4–10) vs. 5 (3–7) | W = 471,031, p < 0.001 *** |
Rate of LNI | 22.76% (193) vs. 18.93% (396) | χ2 = 5.29, df = 1, p = 0.021 * | 22.76% (192) vs. 25.97% (220) | χ2 = 2.34, df = 1, p = 0.126 |
Rate of LN+ but SLN- | 7.25% (14) vs. 9.85% (39) | χ2 = 0.77, df = 1, p = 0.379 | 7.29% (14) vs. 14.55% (32) | χ2 = 4.73, df = 1, p = 0.030 * |
False-negative rate | 3.63% (7) vs. 5.05% (20) | χ2 = 0.32, df = 1, p = 0.572 | 3.65% (7) vs. 5.91% (13) | χ2 = 0.700, df = 1, p = 0.403 |
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Engels, S.; Michalik, B.; Meyer, L.-M.; Nemitz, L.; Wawroschek, F.; Winter, A. Magnetometer-Guided Sentinel Lymph Node Dissection in Prostate Cancer: Rate of Lymph Node Involvement Compared with Radioisotope Marking. Cancers 2021, 13, 5821. https://doi.org/10.3390/cancers13225821
Engels S, Michalik B, Meyer L-M, Nemitz L, Wawroschek F, Winter A. Magnetometer-Guided Sentinel Lymph Node Dissection in Prostate Cancer: Rate of Lymph Node Involvement Compared with Radioisotope Marking. Cancers. 2021; 13(22):5821. https://doi.org/10.3390/cancers13225821
Chicago/Turabian StyleEngels, Svenja, Bianca Michalik, Luca-Marie Meyer, Lena Nemitz, Friedhelm Wawroschek, and Alexander Winter. 2021. "Magnetometer-Guided Sentinel Lymph Node Dissection in Prostate Cancer: Rate of Lymph Node Involvement Compared with Radioisotope Marking" Cancers 13, no. 22: 5821. https://doi.org/10.3390/cancers13225821