Transrectal ultrasonography in the followup of prostatic carcinoma patients: a new prognostic parameter?

The use of transrectal ultrasonography has opened new perspectives in the diagnosis and followup of patients with prostatic cancer. Our study has concentrated mainly on measurements of prostatic volume in patients treated by castration or external radiotherapy. Patients who underwent castration had stable disease or progression of the metastases from 3 to 10 months after castration. There is a statistically significant difference between the decreases of volume in the 2 groups at all intervals of the study. To date an increase in prostatic volume after an initial decrease has occurred in only 1 patient, who had no evidence of systemic progression. The initial decrease in volume of the primary tumor seems to be a critical parameter for the prediction of progression or stability in patients treated by endocrine manipulation. Transrectal ultrasonography seems not to be of great value in patients treated by external radiotherapy.