Determination of local tumour extension in cases of carcinoma of the prostate.
OBJECTIVE
Since most cases of carcinoma of the prostate (CaP) are still diagnosed at a time when the tumour has already spread beyond the prostatic capsula and therefore is incurable, recent impetus has been given to early detection with the chance of curative therapy.


METHODS
This paper reviews of the literature concerning the ability of prostate-specific antigen (PSA), digital rectal examination (DRE), transrectal ultrasonography (TRUS), TRUS directed sextant biopsies, computerized tomography (CT) and magnetic resonance imaging (MRI) to determine the pathological stage of clinically organ-confined CaP.


RESULTS
The combination of PSA, DRE, TRUS and TRUS directed sextant biopsies yield the best information about the pathological extent of clinically organ-confined CaP. However, while this is true for a cohort of patients, the individual patient may still suffer from locally advanced disease that was unpredictable preoperatively by applying these tests. Positive surgical margins after radical prostatectomy are a logical consequence of advanced disease and therefore will be seen as long as no better clinical staging is available to the urologist and as long as CaP does not get diagnosed earlier in the course of the disease.


CONCLUSIONS
At the present time the determination by PSA, DRE, TRUS and TRUS directed sextant biopsies are the diagnostic procedures of choice for the clinical staging of patients with potentially organ-confined CaP, CT and MRI are unable to markedly enhance the accuracy of clinical staging in this disease.
Wolff
J M
JM
Departmment of Urology, RWTH Aachen, Germany.
Borchers
H
H
Jakse
G
G
D014408:Biomarkers, Tumor / Q000097:blood; D002277:Carcinoma / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008297:Male; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D009363:Neoplasm Proteins / Q000097:blood; D009367:Neoplasm Staging; D010173:Palpation; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography
D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins; D017430:Prostate-Specific Antigen