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Increasing role of prostate specific antigen (PSA) in the clinical staging of prostate cancer patients

par Sassine, Antoine;Schulman, Claude
Référence Acta Chirurgica Austriaca, 25, 1, page (4-7)
Publication Publié, 1993-01

Article révisé par les pairs

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Résumé :

The clinical value of prostate specific antigen (PSA) in the staging of prostatic carcinoma was evaluated in 43 patients who underwent radical retropublic prostatectomy. Preoperative levels of PSA were compared with the final pathological stage obtained from all surgical specimens examined for capsular penetration, seminal vesical invasion and lymph node involvement. PSA level was closely correlated with the volume and the stage of the prostatic carcinoma. All patients with PSA≤10 ng/ml had tumor confined to the gland. All patients with PSA>20 ng/ml had extraprostatic tumor extension (stage C or D). Lymph node involvement is observed in 76.4% when PSA>20 ng/ml, in only 7% of patients with PSA level is between 11 and 20, and is absent in PSA<-10. Capsular invasion is found in 100% of patients with PSA>20 ng/ml, in 57% when PSA is between 11 to 20 ng/ml and absent if PSA<10. Capsular penetration was present in all patients with PSA>20 absent if PSA<10. Seminal vesicles are invaded in 82% with PSA>20, in 21,4% with PSA between 11 and 20 and absent if PSA<10. Patients with histologically proved prostatic carcinoma, PSA>20 ng/ml and negative bone scan can be assumed to have extraprostatic disease and/or lymphatic involvement. Patients with PSA (drawn in the requested conditions) <-10 ng/ml can be considered to have organ confined disease, and can be spared a bone scintigraphy. Our study indicate an increasing role of PSA in the clinical staging of prostate cancer patients. © 1993 Verlag Brüder Hollinek.