Staging of localized prostate cancer: a clinical-pathologic correlation.
Sixty consecutive patients were staged clinically by digital rectal examination, acid phosphatase and bone scan prior to radical retropubic prostatectomy and pelvic lymphadenectomy. Twenty-one patients also had magnetic resonance imaging (MRI) and computerized tomography (CT) of the pelvic. The surgical specimens were step-sectioned for pathologic staging. Understaging was documented in 0% of A2 patients, 27% of B1 patients and 67% of B2 patients. Capsular invasion was found in 12% of B1 and 52% of B2 patients, while seminal vesicle extension was documented in 18% of B1 and 52% of B2 patients. Lymph node metastases occurred in 3% of B1 and 29% of B2 patients. Clinical staging error was related to tumor size, tumor grade and history of prior TURP or radiotherapy. Neither CT scan nor MRI improved the accuracy of the digital rectal examination.
Mukamel
E
E
Departement of Surgery, UCLA School of Medicine 90024.
de Kernion
J B
JB
Hannah
J
J
Barbaric
Z
Z
D002277:Carcinoma / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008297:Male; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010173:Palpation; D011184:Postoperative Period; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D001743:Urinary Bladder / Q000098:blood supply