[Carcinoma of the prostate: correlation between local staging and systemic progression]

Area of Science:

• Urology
• Oncology

Background:

• Prostate cancer management involves significant economic and social costs, often causing patient discomfort.
• Current follow-up protocols include PSA testing, imaging (ultrasound, CT, MRI), bone scans, and X-rays.

Purpose of the Study:

• To simplify prostate cancer follow-up by evaluating the utility of transrectal ultrasound (TRUS) and PSA levels.
• To assess the correlation between clinical course and investigation results in patients treated conservatively.

Main Methods:

• Review of 136 prostate cancer patients treated with hormonal and/or radiation therapy (1984-1995).
• Local staging using the TNM system.
• Transrectal ultrasound (TRUS) evaluating prostate size, volume, echogenic pattern, extracapsular extension, and surrounding tissues.

Main Results:

• A good correlation between clinical course and investigation results was found in 116 patients (85.3%).
• TRUS demonstrated utility in determining local status and predicting clinical course.
• TRUS identified patients with potential urine flow obstruction.

Conclusions:

• TRUS and PSA levels are reliable and cost-effective for prostate cancer follow-up, potentially replacing more expensive imaging.
• Regular TRUS (twice yearly) and PSA monitoring can guide further investigations, reserving them for cases with suspected metastasis.
• TRUS can improve patient quality of life by identifying those who may benefit from treatment for urine flow obstruction.