Comparing clinical staging plus transrectal ultrasound with surgical-pathologic staging of prostate cancer

Perrapato, Scott D.; Carothers, George G.; Maatman, Thomas J.; Soechtig, C E

doi:10.1016/0090-4295(89)90004-6

Cited by 25 publications

(6 citation statements)

References 8 publications

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“…TRUS undoubtedly provides more accurate staging than a DRE but still lacks complete accuracy for clinically localized prostate cancer [ 5–7]. In an effort to establish the staging capability of endorectal coil MRI (eMRI) in organ‐confined prostatic carcinoma, we compared images obtained on TRUS and eMRI with the histopathological findings.…”

Section: Introductionmentioning

confidence: 99%

A comparison of transrectal ultrasonography and endorectal magnetic resonance imaging in the local staging of prostatic carcinoma

Ekici¹,

Ozen²,

Agˇildere³

et al. 1999

BJU International

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Objective To compare the staging accuracy of transResults Endorectal coil MRI was more sensitive than TRUS for detecting both ECE, SVI and the site of ECE rectal ultrasonography (TRUS) and endorectal magnetic resonance imaging (eMRI) for organ-confined involvement in organ-confined prostatic carcinoma. TRUS was more accurate than eMRI for detecting the prostatic carcinoma. Patients and methods Twenty-five patients with clinisite of SVI involvement. However, the overall staging accuracy rates for both imaging modalities were equal. cally confined prostatic adenocarcinoma were evaluated to be candidates for radical prostatectomy. AllConclusions Neither TRUS nor eMRI was significantly better than the other for determining the local extent underwent TRUS and eMRI before surgery. Imaging findings evaluated prospectively in each patient of prostatic carcinoma. Therefore, TRUS should be the study of choice until MRI technology improves suBcwere extracapsular extension (ECE), seminal vesicle invasion (SVI) and the site of involvement. The results iently in the preoperative staging of localized prostate cancer. of the imaging techniques were compared with the histopathological findings. As two patients with Keywords Prostate cancer, transrectal ultrasonography, MRI, staging, sensitivity, specificity, accuracy metastatic lymph nodes (detected on frozen-section examination during surgery) were spared radical prostatectomy, the final evaluation included 23 patients.localized prostate cancer [5][6][7]. In an eCort to establish

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Section: Introductionmentioning

confidence: 99%

A comparison of transrectal ultrasonography and endorectal magnetic resonance imaging in the local staging of prostatic carcinoma

Ekici¹,

Ozen²,

Agˇildere³

et al. 1999

BJU International

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“…We [3][4][5]. MR imaging using a body coil has also been used in the local staging of prostate cancer and provided better information than did DRE alone [6,7] …”

Section: Objectivementioning

confidence: 99%

Local staging of prostatic carcinoma: comparison of transrectal sonography and endorectal MR imaging.

Presti¹,

Hricak²,

Narayan³

et al. 1996

American Journal of Roentgenology

130

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“…Unfortunately, of the 16 patients with pathologically established extraprostatic disease, 10 (62%) were understaged by TRUS. Perrapato and colleagues 32 report a similar experience, with TRUS understaging 23 of 25 instances of microscopic capsular penetration. Additionally, they noted difficulty in identifying A2(T1b) disease within the transition zone.…”

Section: Andriole and Colleaguesmentioning

confidence: 56%

Prostate Cancer Imaging

Berman

Brodsky

1998

Cancer Control

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This regular feature will enhance your knowledge of imaging technology in oncologic diagnosis, treatment, and evaluation. Natural HistoryCarcinoma of the prostate is the most common malignancy other than skin cancer in American men. In 1992, some 132,000 men were diagnosed with the disease and 32,000 died of it.1 More ominously, it is projected that deaths will increase by 37% and new diagnoses by 90% by the year 2000 because of the aging of the population. 2 Unique among malignancies, early-stage prostate cancer presents the clinician with the dilemma of whether or not available curative treatment should be given. 3 For those who do undergo treatment, cure is likely (and treatment justified) if indeed the disease is confined to the gland. 4,5 Staging of Prostate CancerTo date, the American Urologic Association staging system, based on that of Whitmore and Jewett, is the one most widely used in North America. 6 Stage A represents inapparent tumors discovered incidental to transurethral resection performed to relieve symptoms of urinary obstruction. Such A1 tumors, seen in three or fewer microscopic foci, are small in volume and usually observed. The larger A2 tumors are considered more aggressive and are often treated. Stage B tumors, like stage A, are confined to the gland but by definition are palpable. Tumors smaller than 1.5 cm and confined to one lobe with normal glandular tissue surrounding on three sides are classified as B1; larger tumors confined to the gland are B2. Stage C represents disease that has traversed the capsule (C1) or involves the seminal vesicles (C2). Stage D disease is metastatic.The increasing occurrence of prostate cancer diagnosed because of prostate-specific antigen (PSA) elevation without other findings to recommend biopsy 7 has presented the need for a third classification of nonpalpable disease. This need, along with the desire to develop a common classification with the International Union Against Cancer, prompted the AJCC to introduce its TNM clinical staging system in 1992. 8 Stages T1a and T1b correspond to A1 and A2. Stage T1c accommodates prostate cancers for which elevation of PSA was the only finding leading to biopsy. Stage T2a tumor involves half a lobe or less. Stage T2b tumor involves more than one half but no more than one lobe, while T2c involves both lobes. The T2 designation is applied to both palpable tumors and to tumors that, although not palpable, are visisble on ultrasound. Stage T3 tumor is extraprostatic; T3a is unilateral and T3b is bilateral extraprostatic disease. Stage T3c tumor invades the seminal vesicles, and stage T4 invades adjacent organs or the pelvic side wall. Ohori and colleagues9 reported on the correlation between this AJCC staging system and step-sectioned pathology review of 400 prostatectomy specimens. The aim of the study was to establish whether clinical staging could predict important pathologic differences. Their comparison of clinical and pathologic staging showed clear correlation between the two, with larger mean tumor volume and g...

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Comparing clinical staging plus transrectal ultrasound with surgical-pathologic staging of prostate cancer

Cited by 25 publications

References 8 publications

A comparison of transrectal ultrasonography and endorectal magnetic resonance imaging in the local staging of prostatic carcinoma

A comparison of transrectal ultrasonography and endorectal magnetic resonance imaging in the local staging of prostatic carcinoma

Local staging of prostatic carcinoma: comparison of transrectal sonography and endorectal MR imaging.

Prostate Cancer Imaging

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