Operative staging of apparently localized adenocarcinoma of the prostate: Results in fifty unselected patients. I. Experimental design and preliminary results

Gordon R. Ray, David A. Pistenma, Ronald A. Castellino, Richard L. Kempson, Edwin Meares, Malcolm A. Bagshaw

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

The design and details of a prospective, randomized study protocol involving bipedal lymphography and exploratory laparotomy with selective node biopsy in patients with apparently localized adenocarcinoma of the prostate are presented. The analysis includes the results of selected diagnostic tests, and an assessment of the accuracy of clinical vs. surgical staging in 50 unselected patients. Lymphatic metastases were found at the time of diagnostic laparotomy in 18 of the 50 patients (36%). Both increasing size (advanced T stage) and decreasing differentiation of the primary tumor were associated with an increased incidence of lymph node metastases. Of 25 patients with T1 and T2 tumors (Stage B), and 25 patients with T3 tumors (Stage C), lymphatic dissemination was found in 20 and 52%, respectively. Eleven of 20 patients (55%) with poorly differentiated tumors had lymph node metastasis, compared with only 2 of 11 patients (18%) with well‐differentiated tumors. Twelve patients had a change in their clinical stage following exploratory laparotomy; in eight the stage was increased and in four it was decreased. Of 18 patients with lymphatic metastases, some of which were extensive and most of which were associated with increased serum acid phosphatase values, no evidence of concurrent bony or visceral dissemination was found. Although preliminary, this finding should stimulate the search for effective treatment in these patients who were previously thought to be incurable on the basis of probable vascular dissemination.

Original languageEnglish (US)
Pages (from-to)73-83
Number of pages11
JournalCancer
Volume38
Issue number1
DOIs
StatePublished - 1976

Fingerprint

Prostate
Adenocarcinoma
Research Design
Laparotomy
Lymphatic Metastasis
Neoplasms
Lymph Nodes
Neoplasm Metastasis
Lymphography
Acid Phosphatase
Routine Diagnostic Tests
Blood Vessels
Prospective Studies
Biopsy
Incidence
Serum

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Operative staging of apparently localized adenocarcinoma of the prostate : Results in fifty unselected patients. I. Experimental design and preliminary results. / Ray, Gordon R.; Pistenma, David A.; Castellino, Ronald A.; Kempson, Richard L.; Meares, Edwin; Bagshaw, Malcolm A.

In: Cancer, Vol. 38, No. 1, 1976, p. 73-83.

Research output: Contribution to journalArticle

Ray, Gordon R. ; Pistenma, David A. ; Castellino, Ronald A. ; Kempson, Richard L. ; Meares, Edwin ; Bagshaw, Malcolm A. / Operative staging of apparently localized adenocarcinoma of the prostate : Results in fifty unselected patients. I. Experimental design and preliminary results. In: Cancer. 1976 ; Vol. 38, No. 1. pp. 73-83.
@article{3ab2cc617e404063b8c7274ab830de98,
title = "Operative staging of apparently localized adenocarcinoma of the prostate: Results in fifty unselected patients. I. Experimental design and preliminary results",
abstract = "The design and details of a prospective, randomized study protocol involving bipedal lymphography and exploratory laparotomy with selective node biopsy in patients with apparently localized adenocarcinoma of the prostate are presented. The analysis includes the results of selected diagnostic tests, and an assessment of the accuracy of clinical vs. surgical staging in 50 unselected patients. Lymphatic metastases were found at the time of diagnostic laparotomy in 18 of the 50 patients (36{\%}). Both increasing size (advanced T stage) and decreasing differentiation of the primary tumor were associated with an increased incidence of lymph node metastases. Of 25 patients with T1 and T2 tumors (Stage B), and 25 patients with T3 tumors (Stage C), lymphatic dissemination was found in 20 and 52{\%}, respectively. Eleven of 20 patients (55{\%}) with poorly differentiated tumors had lymph node metastasis, compared with only 2 of 11 patients (18{\%}) with well‐differentiated tumors. Twelve patients had a change in their clinical stage following exploratory laparotomy; in eight the stage was increased and in four it was decreased. Of 18 patients with lymphatic metastases, some of which were extensive and most of which were associated with increased serum acid phosphatase values, no evidence of concurrent bony or visceral dissemination was found. Although preliminary, this finding should stimulate the search for effective treatment in these patients who were previously thought to be incurable on the basis of probable vascular dissemination.",
author = "Ray, {Gordon R.} and Pistenma, {David A.} and Castellino, {Ronald A.} and Kempson, {Richard L.} and Edwin Meares and Bagshaw, {Malcolm A.}",
year = "1976",
doi = "10.1002/1097-0142(197607)38:1<73::AID-CNCR2820380114>3.0.CO;2-Z",
language = "English (US)",
volume = "38",
pages = "73--83",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "1",

}

TY - JOUR

T1 - Operative staging of apparently localized adenocarcinoma of the prostate

T2 - Results in fifty unselected patients. I. Experimental design and preliminary results

AU - Ray, Gordon R.

AU - Pistenma, David A.

AU - Castellino, Ronald A.

AU - Kempson, Richard L.

AU - Meares, Edwin

AU - Bagshaw, Malcolm A.

PY - 1976

Y1 - 1976

N2 - The design and details of a prospective, randomized study protocol involving bipedal lymphography and exploratory laparotomy with selective node biopsy in patients with apparently localized adenocarcinoma of the prostate are presented. The analysis includes the results of selected diagnostic tests, and an assessment of the accuracy of clinical vs. surgical staging in 50 unselected patients. Lymphatic metastases were found at the time of diagnostic laparotomy in 18 of the 50 patients (36%). Both increasing size (advanced T stage) and decreasing differentiation of the primary tumor were associated with an increased incidence of lymph node metastases. Of 25 patients with T1 and T2 tumors (Stage B), and 25 patients with T3 tumors (Stage C), lymphatic dissemination was found in 20 and 52%, respectively. Eleven of 20 patients (55%) with poorly differentiated tumors had lymph node metastasis, compared with only 2 of 11 patients (18%) with well‐differentiated tumors. Twelve patients had a change in their clinical stage following exploratory laparotomy; in eight the stage was increased and in four it was decreased. Of 18 patients with lymphatic metastases, some of which were extensive and most of which were associated with increased serum acid phosphatase values, no evidence of concurrent bony or visceral dissemination was found. Although preliminary, this finding should stimulate the search for effective treatment in these patients who were previously thought to be incurable on the basis of probable vascular dissemination.

AB - The design and details of a prospective, randomized study protocol involving bipedal lymphography and exploratory laparotomy with selective node biopsy in patients with apparently localized adenocarcinoma of the prostate are presented. The analysis includes the results of selected diagnostic tests, and an assessment of the accuracy of clinical vs. surgical staging in 50 unselected patients. Lymphatic metastases were found at the time of diagnostic laparotomy in 18 of the 50 patients (36%). Both increasing size (advanced T stage) and decreasing differentiation of the primary tumor were associated with an increased incidence of lymph node metastases. Of 25 patients with T1 and T2 tumors (Stage B), and 25 patients with T3 tumors (Stage C), lymphatic dissemination was found in 20 and 52%, respectively. Eleven of 20 patients (55%) with poorly differentiated tumors had lymph node metastasis, compared with only 2 of 11 patients (18%) with well‐differentiated tumors. Twelve patients had a change in their clinical stage following exploratory laparotomy; in eight the stage was increased and in four it was decreased. Of 18 patients with lymphatic metastases, some of which were extensive and most of which were associated with increased serum acid phosphatase values, no evidence of concurrent bony or visceral dissemination was found. Although preliminary, this finding should stimulate the search for effective treatment in these patients who were previously thought to be incurable on the basis of probable vascular dissemination.

UR - http://www.scopus.com/inward/record.url?scp=0017191426&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0017191426&partnerID=8YFLogxK

U2 - 10.1002/1097-0142(197607)38:1<73::AID-CNCR2820380114>3.0.CO;2-Z

DO - 10.1002/1097-0142(197607)38:1<73::AID-CNCR2820380114>3.0.CO;2-Z

M3 - Article

C2 - 820425

AN - SCOPUS:0017191426

VL - 38

SP - 73

EP - 83

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 1

ER -