Predittività della stadiazione clinica nel carcinoma clinicamente localizzato: Clinical staging accuracy in clinically localised carcinoma

Abstract

Usual clinical methods (DRE, CT, MRI) are poorly accurate in prostate cancer staging. In our experience on 265 patients with apparently localised prostate cancer eligible for radical prostatectomy, in 150 cases an extraglandular tumour extension was observed at the definitive pathological examination, with a 56.6% clinical understaging rate. Comparing pre-operative seric PSA and tumour grading with pathological stage we noted a lack of accuracy in correctly predicting tumour stage. In the near future it will be necessary to improve clinical staging methods in order to obtain a better selection of patients for radical prostatectomy. Transrectal ultrasound might be useful, when combined with the biopsy of the gland and the nearby tissues (bladder neck, seminal vesicles), in making the histological presurgical grading closer to the true tumour grade.