Tumor volume and stage in carcinoma of the prostate detected by elevations in prostate specific antigen

We reviewed the surgical specimen from 142 men undergoing radical prostatectomy for prostate cancer detected because of an elevation in serum prostate specific antigen alone. No patient had a palpable abnormality suggestive of cancer. One patient had no identifiable tumor in the radical prostatectomy specimen, 8 (6%) had only a few high power microscopic fields showing cancer, 40 (28%) had an estimated tumor volume of less than 1 cc and 93 (65%) had a tumor volume of greater than 1 cc. Surgical margins were positive in 37 patients (26%) and negative in 105 (73%). Most patients with cancer detected because of modest elevation in prostate specific antigen, even without palpable abnormalities, have a clinically significant tumor volume and are good candidates for radical prostatectomy.