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.