Prostate Cancer Severity No Influence on Recurrence

Clinical stage incorrectly assigned in one-third of patients

TUESDAY, Nov. 23 (HealthDay News) -- Practitioners frequently err in determining the severity of prostate cancer, but clinical stage does not appear to influence risk of recurrence after surgical treatment, according to research published online Nov. 22 in Cancer.

Adam C. Reese, M.D., of the University of California at San Francisco, and colleagues compared digital rectal examination (DRE) and transrectal ultrasound (TRUS) findings with practitioner-reported staging in 3,875 men with localized prostate cancer.

The researchers found that clinical stage had been incorrectly assigned in 1,370 (35.4 percent) of the men and resulted more often in patient downstaging than in patient upstaging (55.1 versus 44.9 percent). Incorrect staging was more likely to occur in men with TRUS lesions than in those with abnormal DRE findings (65.8 versus 38.2 percent). The researchers found no association between clinical state and post-radical prostatectomy recurrence, even after they corrected for staging errors.

"Errors in applying clinical staging criteria for localized prostate cancer are common. TRUS findings are frequently disregarded, and practitioners incorrectly incorporate biopsy results when assigning stage. However, staging errors do not appear to account for the inconsistent reliability of clinical stage in predicting prostate cancer outcomes. These findings further challenge the utility of a DRE-based and/or TRUS-based staging system for risk assessment of localized prostate cancer," the authors write.

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