The value and role of percutaneous pelvic lymph node aspiration biopsy in definitive staging of prostatic and bladder carcinoma.

Percutaneous fluoroscopy-guided aspiration biopsy of the pelvic nodes was performed for staging in 136 nodal chains of 26 patients with clinically localized carcinoma of the prostate and in 14 patients with bladder cancer. The fine-needle aspiration biopsy had an overall accuracy of 97.5%, sensitivity of 94.11% and specificity of 100%. In the management of prostatic cancer, the positive aspiration biopsy may be considered a definitive diagnostic means for determining tumor stage. The negative aspirations may be accepted as definitive diagnostic staging procedure too, since the sensitivity of the method is of 93.3% in patients with prostatic carcinoma. As the presence or absence of nodal metastasis cannot be predicted accurately on the basis of the T or P category of the primary tumor in patients with bladder carcinoma, the fine-needle aspiration biopsy may have a prominent role in accurate clinical stage determination, for a rational application of the treatment.