PROSTATE-CANCER SCREENING BEFORE AND AFTER ABDOMINOPERINEAL RESECTION- RECOMMENDATIONS, BIOPSY, AND THERAPEUTIC TECHNIQUES

Background. The purpose of this Study was to determine the incidence a nd mortality rate of prostate cancer in men without a rectum at a sing le institution. The usefulness of serum prostate specific antigen (PSA ) to screen for prostate cancer in men without a rectum was defined. I mproved biopsy techniques and therapeutic options were developed in th ose with elevated levels. Methods. We undertook a retrospective review of 65 men who underwent an abdominoperineal resection. Twenty-five of these men underwent serum PSA determinations (mean age, 68 years). Re sults. Four (16%) of 25 patients had elevated PSA levels. Three of the se Jour men and two additional patients (one before the availability o f PSA and one with normal serum PSA level) were Sound to have biopsy-p roven prostate cancer. Two men (3% of the 65 patient population) died of metastatic prostate cancer.Conclusions. We believe that men about t o undergo an abdominoperineal resection should have a preoperative ser um PSA measurement, Moreover, we recommend that men older than 49 year s of age (older than 39 years for those with positive family histories ) without a rectum should have annual serum PSA determinations as is r ecommended for the general male population at large. If an elevated se rum PSA level is discovered, the transperineal ultrasonogram-guided bi opsy technique offers an effective method to detect peripheral zone pr ostate cancers.