Improved accuracy of computerized tomography based clinical staging in low stage nonseminomatous germ cell cancer using size criteria of retroperitoneal lymph nodes.

PURPOSE

We evaluated the significance of retroperitoneal lymph nodes detected by computerized tomography (CT) of low stage nonseminomatous germ cell tumor patients.

MATERIALS AND METHODS

A blind retrospective review of 143 CTs of low stage nonseminomatous germ cell tumor revealed pathological stage A disease on 89 (62.2%) and pathological stage B disease on 54 (37.8%). A multivariate logistic regression model was used to evaluate the relationships between diameter of the retroperitoneal nodes detected in these CTs and pathological stage.

RESULTS

Based on this model, as the diameter of the nodes increased within a 0 to 25 mm. range, the likelihood of pathological stage B disease increased in a continuous fashion. Using a 3 mm. threshold to define nonmetastatic nodes the sensitivity and negative predictive value of CT based staging was 90%.

CONCLUSIONS

This measurement scheme improves the accuracy of staging compared to conventional methods.