title: EUS for locoregional staging of prostate cancer--a pilot study.
abstract: 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.
authors.affiliation: Gastrointestinal Endoscopy Unit, University of São Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Everson L A
authors.initials: EL
authors.lastname: Artifon
authors.forename: Paulo
authors.initials: P
authors.lastname: Sakai
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ishioka
authors.forename: Adriano F
authors.initials: AF
authors.lastname: Silva
authors.forename: Fauze
authors.initials: F
authors.lastname: Maluf
authors.forename: Dalton
authors.initials: D
authors.lastname: Chaves
authors.forename: Sergio
authors.initials: S
authors.lastname: Matuguma
authors.forename: Antonio
authors.initials: A
authors.lastname: Pompeo
authors.forename: Antonio M
authors.initials: AM
authors.lastname: Lucon
authors.forename: Miguel
authors.initials: M
authors.lastname: Srougi
authors.forename: Manoop S
authors.initials: MS
authors.lastname: Bhutani
mesh_terms: 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