Update on the Appropriate Staging Evaluation for Newly Diagnosed Prostate Cancer

No AccessJournal of UrologyClinical Urology: Review Article1 Sep 1997Update on the Appropriate Staging Evaluation for Newly Diagnosed Prostate Cancer Gerard J. O'Dowd, Robert W. Veltri, Roberto Orozco, M. Craig Miller, and Joseph E. Oesterling Gerard J. O'DowdGerard J. O'Dowd , Robert W. VeltriRobert W. Veltri , Roberto OrozcoRoberto Orozco , M. Craig MillerM. Craig Miller , and Joseph E. OesterlingJoseph E. Oesterling View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)64295-2AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Prostate cancer clinical staging methods and decision support tools were reviewed to assess their accuracy to predict pathological staging results and determine what comprises an appropriate clinical staging evaluation. Materials and Methods: The MEDLINE data base was searched and 238 abstracts were obtained. Data were extracted from 142 articles that evaluated the preoperative accuracy of digital rectal examination, prostate specific antigen, prostatic acid phosphatase, systematic biopsy parameters (including Gleason scoring), seminal vesicle biopsy, various imaging studies and pelvic lymphadenectomy versus pathological staging results. The sensitivity, specificity and accuracy rates were calculated and tabulated from the reported data on each method or decision support tools for organ confined, nonorgan confined and lymph node metastatic tumor. Results: Decision support tools based on logistic regression analysis, which combine several statistically independent staging parameters, had greater accuracy than any single clinical staging method alone. The most accurate decision support tools for clinical staging combined digital rectal examination (T stage), systematic biopsy parameters (including Gleason scoring) and prostate specific antigen. Conclusions: The components that comprise the most accurate decision support tools for clinical staging represent an appropriate staging evaluation for the newly diagnosed prostate cancer patient in 1997. Limited use of radiographic imaging and seminal vesicle biopsy may be indicated in select patients to detect bone metastases, and plan pelvic lymphadenectomy and surgical therapy. References 1 : Measurement of prostate specific antigen in serum as a screening test for prostate cancer.. New Engl. J. Med.1991; 324: 1156. Google Scholar 2 : Screening for prostatic carcinoma with Prostate Specific Antigen.. J. Urol.1992; 147: 841. Abstract, Google Scholar 3 : Detection of organ confined prostate cancers is increased through PSA based screening.. J.A.M.A.1993; 270: 948. Google Scholar 4 : Comparison of digital rectal examination and serum prostate specific antigen in the early detection of prostate cancer: results of a multicenter clinical trial of 6,630 men.. J. Urol.1994; 151: 1283. 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Volume 158Issue 3September 1997Page: 687-698 Advertisement Copyright & Permissions© 1997 by American Urological Association, Inc.MetricsAuthor Information Gerard J. O'Dowd More articles by this author Robert W. Veltri More articles by this author Roberto Orozco More articles by this author M. Craig Miller More articles by this author Joseph E. Oesterling More articles by this author Expand All Advertisement PDF downloadLoading ...