Transrectal ultrasonography compared to histopathological assessment for local staging of prostatic carcinoma

Transrectal ultrasonography (US) was used to predict tumor stage prior to radical prostatectomy in 59 patients with clinically localized carcinoma of the prostate. In 35 cases, US-guided biopsy was done. Histopathological examination of whole tissue mounts was compared with US findings in 49 cases. The remaining 10 had US-guided biopsies proving extracapsular extension of the tumor. Tumor size, as measured by US, was inadequate to distinguish between organ-confined disease and locally advanced tumor. Strategically taken US-guided biopsies of the periprostatic tissue or seminal vesicles were necessary. In the first 30 (group I) in this series of 59 cases, 18 of 22 tumors with extraprostatic spread (pT3) were understaged. In the last 29 cases (group II) only 6 of 19 pT3 tumors were understaged. After an initial training period, transrectal US, in combination with US-guided biopsy, can prove valuable for the pretherapeutic assessment of local spread of prostatic cancer, and can thus aid in the choice of appropriate treatment.