Identification of high risk pathological node positive XXXX : value of preoperative computerized tomography imaging.

@entity1 @entity39 @entity5 @entity3 @entity204 @entity17539
PURPOSE: @entity1 with @entity17539 , and 3 or more histopathologically proven unilateral metastatic inguinal nodes, and/or extranodal extension, and/or pelvic @entity3 are considered a subgroup with prognostically unfavorable parameters for disease specific @entity204 and local recurrence after inguinal lymphadenectomy. We established radiographic criteria for the preoperative identification of such @entity1 . MATERIALS AND METHODS: Preoperative diagnostic computerized tomography studies of 30 @entity1 with @entity17539 with proven unilateral or bilateral lymph node @entity3 were reviewed independently by 2 radiologists blinded for @entity1 data. All computerized tomography images were analyzed per side (60). Several radiographic criteria were assessed for regional lymph nodes with short-axis diameter 8 mm or greater and/or central @entity39 . Sides were characterized as high risk if histopathology revealed 3 or more metastatic inguinal nodes and/or extranodal extension and/or pelvic nodal involvement. RESULTS: Histopathological nodal involvement was found in 38 sides (63%) including 22 sides (37%) defined as high risk. The presence of central @entity39 and/or irregular nodal border of the regional lymph nodes on the preoperative computerized tomography identified the high risk subgroup with a sensitivity of 95% (21 of 22) and a specificity of 82% (31 of 38). All 7 sides falsely designated as high risk harbored inguinal metastases but they were classified as low risk. The interobserver agreement of each radiographic parameter was almost perfect. CONCLUSIONS: The presence of central @entity39 and/or an irregular nodal border of the regional lymph nodes on preoperative computerized tomography images are accurate and reproducible criteria to identify high risk pathological node positive @entity5 . These criteria can be used for risk stratification and @entity1 counseling.
