PROSTATE-SPECIFIC ANTIGEN OBTAINED UNDER OPTIMAL CONDITIONS DETERMINES EXTRACAPSULAR ADENOCARCINOMA OF THE PROSTATE

Objective To assess the relationship of prostate-specific antigen (PSA) obtained under optimal conditions with the presence or absence of organ-confined prostate cancer following radical prostatectomy. Patients and methods The medical records of 300 consecutive patients who underwent radical retropubic prostatectomy were retrospectively reviewed. Ninety-three patients were excluded who had a pre-operative PSA level potentially altered by various factors (prostate infection, manipulation or instrumentation). Results A pre-operative PSA value <4 ng/mL, accurately predicted pathologically confined disease in 42 of 51 patients (82%) which contrasted with extracapsular disease in 74 of 84 patients (88%) who had a PSA value >10 ng/mL. One of the 53 patients with a PSA >15 ng/mL had organ-confined disease at surgery. Conclusion These data demonstrate that optimal serum PSA values correlate well with pathological stage.