Side-specific correlation between tumor location determined by biopsy and HistoScanning and nodal metastases in prostate cancer

Introduction This study investigates whether it is possible to predict the side of lymph node metastasis in prostate cancer preoperatively by evaluating biopsy or HistoScanning results. Material This is a retrospective study including 56 patients. Prostatectomy, extended lymphadenectomy and lymph node metastasis were chosen as inclusion criteria. We analysed the relation between the preoperatively determined side of the tumour in the prostate and the side of pelvic lymph node metastases. Methods Microsoft (R) Office 365 Excel and IBM (R) SPSS (R) Statistics Subscription were used as statistic tools. For the statistical analysis, the Fisher exact test was employed. P values of <0.05 were rated as statistically significant. Results A significant correlation between the location of the tumour in the prostate determined by biopsy and the side of lymph node metastasis has been shown. A share of 83 % of all patients with unilateral prostate cancer diagnosed by biopsy have lymph node metastases on one side (ipsilateral or contralateral); 75% of those patients have exclusively ipsilateral metastases. The results of using HistoScanning as a diagnostic instrument are not convincing. The histopathological analysis after prostatectomy showed tumour growth in both prostate lobes in 89% of the patients. Conclusion Both biopsy and HistoScanning seem to underestimate the tumour spread in the prostate. Due to this inaccuracy, a recommendation to restrict lymphadenectomy to one side cannot be given although some significant correlation has been found.