Diagnosis and staging of prostatic carcinoma: What is really necessary?

Diagnosis and staging of prostatic carcinoma should be considered in men in whom treatment with curative intent is possible. The primary tools for det ection of cancer are digital rectal examination (DRE) and serum prostate-sp ecific antigen (PSA), whereas transrectal ultrasonography is best used to g uide the needle for biopsy. Staging should be based on the TNM system. The most reliable staging methods include a combination of DRE, PSA and systema tic biopsies for local tumor extension, pelvic lymphadenectomy for regional lymph nodes, and PSA and bone scintigraphy for distant metastases. Compute d tomography a nd magnetic resonance imaging a re not necessary in most cas es. Copyright (C) 1999 S. Karger AG, Basel.