Objective: The objective of the present study was to evaluate the usefulness of the combined systematic biopsy with serum prostate-specific antigen-α1-antichymotrypsin complex (PSA-ACT) level to predict the extent of prostate cancer. Materials and Methods: Sixty-two patients with clinically organ-confined disease who underwent radical prostatectomy were evaluated for serum PSA and PSA-ACT levels, systematic biopsy, and the pathological stage. Results: The incidence of extraprostatic disease in patients with more than half the biopsy cores positive or ≧8 ng/ml PSA-ACT was significantly higher than those with less than half positive or <8 ng/ml PSA-ACT, respectively, whereas cancer in bilateral lobes or ≧10 ng/ml PSA could not be used as a predictor of extraprostatic disease. Furthermore, in those with more than half the biopsy cores positive and ≧8 ng/ml PSA-ACT or those with more than half the biopsy cores positive and ≧10 ng/ml PSA, extraprostatic disease was significantly more common than in those with less than half positive and <8 ng/ml PSA-ACT or those with less than half positive and <10 ng/ml PSA, respectively. However, the incidence of extraprostatic disease predicted by these three variables was not significantly better than those by the two variables (percentage positive biopsy cores plus serum PSA-ACT or PSA). Conclusions: The combined systematic biopsy with serum PSA-ACT or PSA could be used as a useful predictor for the extent of prostate cancer. Patients with more than half the biopsy cores positive and ≧8 ng/ml PSA-ACT or ≧10 ng/ml PSA could avoid a prostatectomy because there is a high probability that they have extraprostatic disease.

Keywords:
Prostate cancer, Staging, PSA-ACT, Systematic biopsy
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© 2002 S. Karger AG, Basel
2002
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