EUS for locoregional staging of prostate cancer--a pilot study.
BACKGROUND
This was a pilot study on EUS for locoregional evaluation of prostate cancer.


OBJECTIVE
Our purpose was to evaluate radial and linear-array EUS in locoregional prostate cancer staging.


METHODS
From April to December 2005, 23 patients were referred to the Department of Urology with a confirmed or highly suspected diagnosis of prostate cancer on the basis of cytohistologic examination of fragments obtained by transrectal US-guided biopsy or transuretheral means. After institutional review board approval, informed consent was obtained from all patients.


METHODS
An endosonographer and a radiologist with expertise in prostate imaging performed radial and linear EUS examinations without knowledge of the stage of prostate cancer of the referred patients.


METHODS
Systematic prostatic evaluation by EUS. All patients underwent prostatectomy, and the surgical specimens were analyzed and correlated with EUS findings.


RESULTS
Mean age was 65.91 years, and the mean prostate-specific antigen level was 27.73 ng/mL. Histopathologic study of the surgical specimen revealed adenocarcinoma in 20 of 23, atypical adenomatous hyperplasia in 2 of 23, and sclerosing adenosis in 1 of 23. Staging by EUS for T stage showed different sensitivity (S), specificity (E), and accuracy (A) according to the degree of tumor invasiveness as follows: T1 (S: 51.3%, E: 53.2%, A: 49.1%); T2 (S: 100%, E: 91.67%, A: 95%); T3 (S: 100%, E: 100%, A: 100%). In 3 (3/23) patients EUS did not find a defined lesion, but the surgical specimen showed T1 stage cancer. EUS staging for N stage showed 62.5% sensitivity, 58.33% specificity, and 60% accuracy for N0. Regarding N1, 58.3% sensitivity, 52.50% specificity, and 60% accuracy were found.


CONCLUSIONS
Uncontrolled, nonrandomized study.


CONCLUSIONS
EUS presented high sensitivity, specificity, and accuracy for prostate cancer staging.
Artifon
Everson L A
EL
Gastrointestinal Endoscopy Unit, University of São Paulo Medical School, Sao Paulo, Brazil.
Sakai
Paulo
P
Ishioka
Shinichi
S
Silva
Adriano F
AF
Maluf
Fauze
F
Chaves
Dalton
D
Matuguma
Sergio
S
Pompeo
Antonio
A
Lucon
Antonio M
AM
Srougi
Miguel
M
Bhutani
Manoop S
MS
D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D003937:Diagnosis, Differential; D019160:Endosonography / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging / Q000379:methods; D010865:Pilot Projects; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D012007:Rectum; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014521:Urethra