To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: CUA: Serial Trans-Rectal Ultrasound Poor Predictor Of Prostate Disease Progress URL: http://www.pslgroup.com/dg/1FF826.htm Doctor's Guide June 28, 2001
By Cameron Johnston Special to DG News TORONTO, ON -- June 28, 2001 -- Trans-rectal ultrasound (TRUS) is a poor predictor of prostate disease progression. Clinicians who recommend watchful waiting for their patient with prostate cancer should, therefore, exercise a great deal of caution when interpreting TRUS results. In a presentation at the annual meeting of the Canadian Urological Association, Dr. Richard Choo, a radiation-oncologist with the Toronto Sunnybrook Regional Cancer Centre said only one quarter of serial TRUS will detect changes to the prostate that are consistent with disease progress. TRUS findings might not have any correlation at all with clinical, biochemical or histological progression of the disease.. "Up until now, we have never had a study to look at the usefulness of TRUS in evaluating these men for disease progress. Watchful waiting has been the preferred management for a lot of men, but if, and when progress has been detected, it has usually been through methods other than ultrasound," he said. Dr. Choo's study involved 174 men who were counseled appropriately and agreed to undergo watchful waiting for their low grade tumors (t1b, no node involvement, not metastasis). The men underwent regular examinations including PSA (prostate specific antigen) measurements, and ultrasound exams at least every six months. Over the course of five years, 28 men went on to develop more aggressive cancer warranting appropriate treatment. Those men had had a mean of three ultrasound exams each (range 1-6), but only seven of them showed any signs of disease progress according to the scans. Instead, the disease progress was detected biochemically, histologically or through a digital rectal exam (DRE). Of the nine men who showed disease progress according to DRE, only four showed any progress on TRUS. Of the 13 who showed progress according to PSA measurements, only one showed any indication of disease progress on TRUS, and that was an enlarging nodule. Finally, among six patients who showed histological progress, two showed any signs of progress on TRUS. Thirteen men (of the 28) had no baseline lesions, but two developed new nodules that were consistent with progression. Similarly, only three of 10 with one peripheral lesion, and two of five with two lesions went on to develop new lesions that were detected by TRUS and were consistent with disease progression. Among the remaining 136 who had two or more ultrasounds, there was no correlation between the rate of PSA change and changes in either prostate volume or the number of peripheral zone hypoechoic lesions, Dr. Choo said. "Based on these findings, the use of serial TRUS exams in men with known, but untreated prostate cancer seems to be of limited value as a determinant of disease progression," Dr. Choo said. Dr. Choo's study was published this week in the British Journal of Urology International 2001; 87: 643-647. --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.