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Detection of clinical unilateral T3a prostate cancer - by digital rectal examination or transrectal ultrasonography?

Abstract：

OBJECTIVE:To assess, in a retrospective study, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of digital rectal examination (DRE), transrectal ultrasonography (TRUS) and the combination of both in unilateral clinical T3a (cT3a) prostate cancer. PATIENTS AND METHODS:The long-term outcome of surgical treatment for locally advanced prostate cancer is very good and surpasses that for radiotherapy outcomes, so it is anticipated that surgical management for cT3a disease will become more important, but staging methods for cT3a disease are not well studied. Between 1990 and 2004, 2240 patients had a radical prostatectomy at our institution; 267 were diagnosed as having clinical cT3a prostate cancer either by DRE or TRUS. The final histopathology was compared with the findings of DRE and TRUS. The sensitivity, specificity, PPV and NPV for DRE, TRUS and the combination of both were calculated. RESULTS:The sensitivity, specificity, PPV and NPV by DRE only was 90.9%, 15.8%, 47.2% and 67.7%, by TRUS only was 80.2%, 25.3%, 47.1% and 60.7%, and by both DRE and TRUS was 71.1%, 41.1%, 50.0% and 63.2%. Although the sensitivity was lower in the combined group, it had the highest specificity (41.1%) and PPV (50.0%). The combination of DRE and TRUS can detect T3a prostate cancer more accurately than either method alone. CONCLUSION:Until data on staging methods like magnetic resonance imaging become available, the combination of DRE and TRUS is advisable in selecting cT3a patients for primary radical prostatectomy.

journal_name

BJU Int

journal_title

BJU international

authors

Hsu CY,Joniau S,Oyen R,Roskams T,Van Poppel H

doi

10.1111/j.1464-410X.2006.06452.x

subject

Has Abstract

pub_date

2006-11-01 00:00:00

pages

982-5

issue

5

eissn

1464-4096

issn

1464-410X

pii

BJU6452

journal_volume

98

pub_type

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