Preoperative estimate of extent of disease in T1c: how well can we predict?

Serum prostate-specific antigen testing and systematic ultrasound-guided biopsy has improved our ability to diagnose low-stage, nonpalpable prostate cancer. With improvement of diagnostic sensitivity, the risk of finding clinically insignificant or "latent" prostate cancer has likewise increased. The potential morbidity and expense of overdiagnosing and treating latent prostate cancer has necessitated the search for better methods of determining tumor extent and significance. This information may then be used for development of individual treatment strategies. Serum prostate-specific antigen level, prostate-specific antigen density, and characterization of biopsy tissue appear to be reasonably accurate methods of estimating tumor extent.