Use of Fine Needle Aspiration for Detection of Stage a Prostatic Carcinoma Before Transurethral Resection of the Prostate: A Clinical Trial

Abstract
The incidence of stage A prostatic carcinoma is approximately 10 per cent. We performed a clinical trial to determine if pre-prostatectomy fine needle aspiration could detect reliably stage A prostatic carcinoma. In 102 men with clinically staged benign disease by digital examination we performed a 4-quadrant fine needle aspiration of the prostate before prostatectomy. The cytological diagnosis of the aspirate was compared to the pathological diagnosis obtained at prostatectomy in all patients. The incidence of stage A prostatic carcinoma in this group of patients was 18.6 per cent (19 of 102 men). Sufficient aspirate material for cytological diagnosis was obtained in 98 of 102 men (96 per cent), including 17 with a diagnosis of carcinoma. When adequate diagnostic material was obtained, fine needle aspiration detected all cases of clinical stage A2 prostatic carcinoma but it did not detect stage A1 prostatic carcinoma. There were no false positive diagnoses. We conclude that routine pre-prostatectomy fine needle aspiration of the prostate can be safe, cost-effective and clinically useful.