Prostate‐specific antigen obtained under optimal conditions determines extracapsular adenocarcinoma of the prostate

OBJECTIVE: To assess the relationship of prostate-specific antigen (PSA) obtained under optimal conditions with the presence or absence of organ-confined prostate cancer following radical prostatectomy. PATIENTS AND METHODS: The medical records of 300 consecutive patients who underwent radical retropubic prostatectomy were retrospectively reviewed. Ninety-three patients were excluded who had a pre-operative PSA level potentially altered by various factors (prostate infection, manipulation or instrumentation). RESULTS: A pre-operative PSA value < 4 ng/mL accurately predicted pathologically confined disease in 42 of 51 patients (82%) which contrasted with extracapsular disease in 74 of 84 patients (88%) who had a PSA value > 10 ng/mL. One of the 53 patients with a PSA > 15 ng/mL had organ-confined disease at surgery. CONCLUSION: These data demonstrate that optimal serum PSA values correlate well with pathological stage.