Lymphangiography in Prostatic Carcinoma

The increasing use of external megavoltage radiotherapy for treating prostatic carcinoma with curative intent makes it important to define the extent of the disease, including the extent of lymph node involvement. Of 94 patients with prostatic carcinoma who had lymphangiograms, 18 underwent "staging" laparotomy within weeks of the examination. The lymphangiograms of these 18 patients, all of whom clinically had carcinoma localized in the prostatic bed, were retrospectively reviewed, and the roentgenographic findings were histologically correlated with the excised lymph nodes. Nine of 18 patients (50%) who had no prelymphangiographic or preoperative evidence of metastases had tumor metastatic to lymph nodes. Of these nine patients, seven had tumor extending as high as the para-aortic lymph nodes. The lymphangiograms correctly demonstrated the sites of nodal metastases in eight of these nine cases (89%).