Endoscopic-ultrasound-guided tissue sampling facilitates the detection of local recurrence and extra pelvic metastasis in pelvic urologic malignancy

Ferga C. Gleeson, Jonathan E. Clain, Robert Jeffrey Karnes, Elizabeth Rajan, Mark Topazian, Kenneth Ke Ning Wang, Michael J. Levy

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Pelvic lymph node dissection is the gold standard for assessing nodal disease in prostate or bladder cancer and is superior to CT, MRI and PET staging. Endoscopic ultrasound (EUS) provides an alternative, less invasive method of cytohistologic material acquisition, but its performance in pelvic urologic malignancy is unknown. Therefore, our aim was to evaluate the diagnostic accuracy of EUS guided tissue sampling for these malignancies when compared to a composite cytohistologic and surgical gold standard. A median of 3 FNA passes were performed (n = 19 patients) revealing a sensitivity, specificity, PPV and NPV of 94.4% (7299), 100% (2100), 100% (80100) and 50% (198) respectively. The perirectal space was the most frequently sampled location irrespective of the primary urological cancer origin. Final diagnosis established by EUS tissue sampling included bladder cancer (n = 1), bladder cancer local recurrence (n = 8), bladder cancer extra pelvic metastases (n = 1), prostate cancer (n = 2), prostate cancer local recurrence (n = 4), prostate cancer extra pelvic metastases (n = 1), testicular cancer extra pelvic metastases (n = 1) and a benign seminal vesicle (n = 1). EUS guided sampling of the gut wall, lymph nodes, or perirectal space yields suitable diagnostic material to establish the presence of primary, local recurrence or extra pelvic metastases of pelvic urologic malignancy.

Original languageEnglish (US)
Article number219521
JournalDiagnostic and Therapeutic Endoscopy
DOIs
StatePublished - 2012

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Urinary Bladder Neoplasms
Prostatic Neoplasms
Neoplasm Metastasis
Recurrence
Neoplasms
Urologic Neoplasms
Seminal Vesicles
Testicular Neoplasms
Lymph Node Excision
Lymph Nodes
Sensitivity and Specificity

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

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title = "Endoscopic-ultrasound-guided tissue sampling facilitates the detection of local recurrence and extra pelvic metastasis in pelvic urologic malignancy",
abstract = "Pelvic lymph node dissection is the gold standard for assessing nodal disease in prostate or bladder cancer and is superior to CT, MRI and PET staging. Endoscopic ultrasound (EUS) provides an alternative, less invasive method of cytohistologic material acquisition, but its performance in pelvic urologic malignancy is unknown. Therefore, our aim was to evaluate the diagnostic accuracy of EUS guided tissue sampling for these malignancies when compared to a composite cytohistologic and surgical gold standard. A median of 3 FNA passes were performed (n = 19 patients) revealing a sensitivity, specificity, PPV and NPV of 94.4{\%} (7299), 100{\%} (2100), 100{\%} (80100) and 50{\%} (198) respectively. The perirectal space was the most frequently sampled location irrespective of the primary urological cancer origin. Final diagnosis established by EUS tissue sampling included bladder cancer (n = 1), bladder cancer local recurrence (n = 8), bladder cancer extra pelvic metastases (n = 1), prostate cancer (n = 2), prostate cancer local recurrence (n = 4), prostate cancer extra pelvic metastases (n = 1), testicular cancer extra pelvic metastases (n = 1) and a benign seminal vesicle (n = 1). EUS guided sampling of the gut wall, lymph nodes, or perirectal space yields suitable diagnostic material to establish the presence of primary, local recurrence or extra pelvic metastases of pelvic urologic malignancy.",
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AU - Gleeson, Ferga C.

AU - Clain, Jonathan E.

AU - Karnes, Robert Jeffrey

AU - Rajan, Elizabeth

AU - Topazian, Mark

AU - Wang, Kenneth Ke Ning

AU - Levy, Michael J.

PY - 2012

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