PREDICTIVE VALUE OF PROSTATE-SPECIFIC ANTIGEN DENSITY FOR THE PRESENCE OF MICROMETASTATIC CARCINOMA OF THE PROSTATE

Objective. To examine the efficacy of prostate-specific antigen (PSA) density (PSAD; serum PSA/prostate volume) as a predictor of clinical o utcome of patients undergoing radical retropubic prostatectomy for cli nically confined prostate cancer, and its ability to determine the pre sence of micrometastatic disease. Methods. A retrospective analysis of patient outcome as reflected by surgical stage and postoperative PSA was performed with respect to PSAD as determined by preoperative PSA a nd pathologic prostate gland volume. The findings for 107 consecutive patients who underwent radical prostatectomy are reported. Results. PS AD at low values was found to be 90 percent accurate in predicting ope rative success or absence of micrometastatic disease. PSAD at high val ues was shown to be 70 percent accurate in predicting failure. Conclus ions. PSAD appears to be useful in selecting patients for radical pros tatectomy and may be capable of identifying patients with micrometasta tic disease.