Value of transrectal ultrasound in preoperative staging of prostate cancer.

BACKGROUND

The aim of the study was to compare preoperative transrectal ultrasound findings with final histopathological stage after radical prostatectomy to determine the value of TRUS in preoperative staging of prostate cancer.

METHODS

The evaluation was performed as a retrospective study. In 114 radical prostatectomy specimens the histopathological, ultrasound and rectal digital findings were correlated. Mean age of patients was 63 years and in all patients a radical retropubic prostatectomy was performed.

RESULTS

Organ confined PC was found correctly with TRUS in 68% and capsular penetration in 32%. Corresponding findings with digital rectal examination (DRE) were 68% and 17% respectively. Sensitivity of TRUS in organ confined PC (T1-2) was 66.1% (DRE 68.5%), specificity 32.6% (DRE 20%) and positive predictive value 55.7% (DRE 49.3%). Sensitivity, specificity and positive predictive value of TRUS for stage T3 (a,b,c) were 32.6%, 68.4% and 45.5% respectively. A separate evaluation of stage T3c revealed for TRUS: sensitivity 41.2%, specificity 81.8% and positive predictive value 36.8%.

CONCLUSION

On the basis of this retrospective analysis, and due to the low sensitivity and specificity, TRUS is not suitable for adequate preoperative staging of prostatic cancer.