The Value of Prostate Specific Antigen, Digital Rectal Examination, Transrectal Ultrasound, and Transrectal Ultrasound-Guided Biopsy in Prediction of Final Pathologic Diagnosis in Prostate Cancer.
- Author:
Seong Hyun PAICK
1
;
Byong Chang JUNG
;
Dal Woo PARK
;
Jeong Hyun KIM
;
Seong Jin JEONG
;
Seok Soo BYUN
;
Cheol KWAK
;
Sang Eun LEE
Author Information
1. Department of Urology, Seoul National University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Prostate cancer;
Radical prostatectomy;
Prostate specific antigen;
Biopsy;
Gleason score
- MeSH:
Biopsy*;
Diagnosis*;
Digital Rectal Examination*;
Humans;
Lymph Nodes;
Medical Records;
Neoplasm Grading;
Neoplasm Metastasis;
Prostate*;
Prostate-Specific Antigen*;
Prostatectomy;
Prostatic Neoplasms*;
Seminal Vesicles;
Ultrasonography*
- From:Korean Journal of Urology
2001;42(3):313-321
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: We evaluated the clinical utility of preoperative serum prostate specific antigen (PSA), digital rectal examination (DRE), transrectal ultrasound (TRUS), and findings of TRUS-guided biopsies in predicting the final pathologic diagnosis in patients who underwent radical prostatectomy. MATERIALS AND METHODS: The medical records of 53 patients with prostate cancer who underwent radical prostatectomy from september 1995 to June 2000 were reviewed. Pathologic variables evaluated on sextant biopsies included total length and percent of cancer on one core, number of cores involved and Gleason score. Clinical variables included PSA and PSA density (PSAD). Also subjects were divided into two groups; organ-confined group versus non organ-confined group. RESULTS: On final pathologic examination, 38 patients (72%) had organ-confined, 11 patients (21%) had margin positive, 6 patients (11%) had capsular penetration and 6 patients (11%) had seminal vesicle involvement. None had pelvic lymph node metastases. Chi-square analysis demonstrated significant correlations between PSA, PSAD, number of cores involved, total length of cancer on one core and organ-confined prostate cancer. When PSA level was 11 or more, PSAD was 0.34 or more, biopsies had Gleason scores of 7 or more, number of cores involved was two or more, and total length of cancer on one core was 0.4cm or more, possibility of cancer being non organ-confined increased CONCLUSIONS: This study demonstrates that PSA, PSAD, Gleason score in sextant biopsy, number of cores involved, total length of cancer on one core are clinically useful predictors of organ-confined disease. This may help both patients and clinician in selecting the most appropriate therapeutic approach.
