Transrectal ultrasound: impact on clinical staging
May 25th, 2009 Posted in hifuNew data just published by a group at the University of California, San Francisco (UCSF) suggests that, in the current era, transrectal ultrasound (TRUS) provides an accurate means to assess the clinical (pre-treatment) stage of a man’s prostate cancer.
Most clinicians rely on a digital rectal examination (DRE) to assess clinical stage of prostate cancer at the time of diagnosis because of conflicting data from earlier studies in the literature regarding the role of transrectal ultrasonography (TRUS). However, ultrasound technologies and physician experience have improved since most of those early data were published, and so Eisenberg et al. set out to assess the impact of TRUS on the clinical staging of prostate cancer in a contemporary patient cohort.
This paper raises the question of whether TRUS findings should be incorporated into the Partin tables and the Kattan nomograms to improve the accuracy of these widely used prognostic tools in order to improve their accuracy and thereby assist in the selection of appropriate treatments for individual patients. Such improved accuracy may be of particular importance in the use of radiation and other forms of non-surgical treatment, where one does not have the benefit of being able to re-stage the cancer post-surgery by assigning a pathological stage.