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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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