PSA-DETECTED PROSTATE-CANCER - CONTRASTS WITH PALPABLE DISEASE

The clinical and pathologic characteristics of 100 consecutive men wit h clinically localized prostate cancer and staged by radical prostatec tomy were reviewed. Men with impalpable prostate-specific antigen (PSA ) detected cancers (T1c) were contrasted against men with palpable dis ease (TB). Lesions were clinically staged as T1c in 53 men and TB in 4 7 men. Mean serum PSA for men with Tie cancers was 11.8 +/- 0.7 ng/dL (normal: 0 > 4) and 14.1 +/- 1.7 ng/dL for men with TB disease. Histol ogic evaluation revealed a mean Gleason's sum of 6.4 +/- 0.2 (scale: 2 > 10) for T1c lesions and 6.6 +/- 0.2 for men with TB cancers (P = NS ). DNA content was diploid in 67% of T1c cancers and 62% of TB lesions (P = NS). An overall 43% clinical staging error was observed. Extrapr ostatic extension was demonstrated in 36% of Tie cancers and 51% TB le sions (P = NS). PSA-detected cancers were indistinguishable from palpa ble lesions by all measures evaluated. Prostate cancers detected in as ymptomatic men by an elevated PSA should be considered biologically si gnificant lesions. (C) 1995 Wiley-Liss, Inc.