THE COMPARISON OF LOCAL STAGE PERFORMED
BY DIGITAL RECTAL EXAMINATION (TDRE) AND TRANSRECTAL
ULTRASONOGRAPHY (TTRUS) TO HISTOPATHOLOGICAL STAGE (pT)
Article published in Urologia Polska 2000/53/2.
authors
-
Romuald Zdrojowy
- Katedra i Klinika Urologii Akademii Medycznej we Wroc³awiu
Kierownik Kliniki: prof. dr hab. med. J. Lorenz
keywords
-
prostate adenocarcinoma local stage DRE, TRUS
summary
- Objectives. One of the most important factor to introduce the suitable mode
- of treatment in patients with prostate cancer is the proper and accurate local
- stage diagnosis. Its reliability and accuracy is only possible by Comparing to
- histopathological stage. The aim of the study was the appreciation of clinical
- local stage performed by digital rectal examination (TDRE) and transrectal
- ultrasonography (TTRUS) to stage made by histopathological examination of
- radical prostatectomy specimen.
- Material and methods. The clinical local stage of prostate cancer was
- performed by DRE (TDRE) and TRUS (T ). On the base of DRE the tumour
- presence, its size and relationship to adjacent tissues were evaluated, so the
- local stage TDRE was determined. In transrectal ultrasonography the tumour
- size, its relations to prostate capsule and seminal vesicles as well as adjacent
- tissues and organs were evaluated - so the local stage TTRUS was established.
- Finally the clinical local stage (T) was defined as the most advanced local stage
- either in DRE or in TRUS. The clinical stage (T) were compared to pathological
- stage (pT) in 98 men treated later by radical retropubic prostatectomy.
- Results. It was statistically proved, that histopathological stage (pT) was
- significantly different from clinical stage (T) ? = 0.05). The histopathological stage
- pT
- and in 2% clinical understaging was observed. The clinical stage performed by
- ultrasound examination (TTRUS) was the most reliable result compared to
- pathological stage (pT); 87% of TTRUS were consistent to pT (p = 0.0075).
- Up to 80% TDRE were understaged but never TDRE overstaging was observed.
- The DRE sensivity according to cancer extracapsular extension was only 22%
- but specificity was then 100%.
- Conclusions. The clinical stage in men with prostate cancer may differs from
- pathological stage performed after radical prostatectomy specimen examination.
- The stage established by ultrasound examination is the most reliable result
- according to histopathological examination. The local stage performed by DRE
- is more often understaged.
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