R.M.N. in the local staging of prostate cancer. Comparison of digital rectal examination,transrectal ultrasonography,CT-scan and pathological results

Accurate preoperative staging is important for selection of patients for radical retropubic prostatectomy. Twenty-two men with cyto-histological diagnosis of prostate adenocarcinoma were evaluated for local diffusion of the neoplasia prior to radical prostatectomy. Tumors confined to the prostate gland (no capsular penetration, no seminal vesical invasion and negative lynphonode) were determined by digital rectal examination (DRE), transrectal ultrasonography (TRUS), pelvic CT-scan, and MRI and then compared to the pathological results. Correct T-staging and predictive value for tumor confinement were better for TRUS: 77% and 69,2% respectively. Statistically it was not much different from T-staging accuracy and predictive value for tumor confinement of CT-scan and MRI, but DRE proved to be the least accurate. All examinations cannot identify the microscopic extent of the tumor.