Radiology, Vol 178, 201-206, Copyright © 1991 by Radiological Society of North America
Biologic aggressiveness of palpable and nonpalpable prostate cancer: assessment with endosonography
GW Baran, AL Golin, CJ Bergsma, TE Stone, PR Wilson, BA Reichardt, PF Lobert and CS Locke
Department of Radiology, Hackley Hospital, Muskegon, MI 49443-5592.
The biologic aggressiveness of palpable versus nonpalpable prostate cancer
was evaluated in 666 patients studied with endosonography over a 24-month
period. Biologic aggressiveness was defined by a combined histologic and
grade-stage category score. In 314 patients suspected of having prostate
cancer 328 biopsies were performed. Carcinoma was detected in 99 patients,
by means of both palpation and endosonography (n = 80), endosonography
alone (n = 9), and palpation alone (n = 8); two cancers were not detected
with either palpation or endosonography. All patients with normal results
of digital examination had a combined grade-stage category score lower than
9. Fifty-five of 69 patients (80%) with abnormal results of digital
examination and available histologic data had a histologic score of 6 or
higher; 38 of these patients (69%) had a combined grade-stage category
score of 9 or higher. Although the number of patients is small, these data
suggest that nonpalpable cancers are biologically less aggressive than
palpable ones and that the advantage of endosonography over palpation in
detection of clinically significant cancers is limited.
