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Guo Z, He J, Huang L, Wang Z, Hu P, Wang S, Bai Z, Pan J. Prevalence and risk factors of incidental prostate cancer in certain surgeries for benign prostatic hyperplasia: A systematic review and meta-analysis. Int Braz J Urol 2022; 48:915-929. [PMID: 35195386 PMCID: PMC9747035 DOI: 10.1590/s1677-5538.ibju.2021.0653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 12/01/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This study aimed to explore the prevalence and clinical risk factors in patients diagnosed with incidental prostate cancer (IPC) during certain surgeries (transurethral resection of the prostate [TURP], open prostatectomy [OP], and holmium laser enucleation of the prostate [HoLEP]) after clinically suspected benign prostatic hyperplasia (BPH). MATERIALS AND METHODS Literature search of the MEDILINE, Web of Science, Embase, and Cochrane Library databases was performed to identify eligible studies published before June 2021. Multivariate adjusted odds ratios (ORs) and associated 95% confidence intervals (CIs) of the prevalence and clinical risk factors of IPC were calculated using random or fixed-effect models. RESULTS Twenty-three studies were included in the meta-analysis. Amongst the 94.783 patients, IPC was detected in 24.715 (26.1%). Results showed that the chance of IPC detection (10%, 95% CI: 0.07-4.00; P<0.001; I2=97%) in patients treated with TURP is similar to that of patients treated with HoLEP (9%, 95% CI: 0.07-0.11; P<0.001; I2=81.4%). However, the pooled prevalence estimate of patients treated with OP was 11% (95% CI: -0.03-0.25; P=0.113; I2=99.1%) with no statistical significance. We observed increased incidence of IPC diagnosis after BPH surgery amongst patients with higher prostate-specific antigen (PSA) level (OR: 1.13, 95% CI: 1.04-1.23; P=0.004; I2=89%), whereas no effect of age (OR: 1.02, 95% CI: 0.97-1.06; P=0.48; I2=78.8%) and prostate volume (OR: 0.99, 95% CI: 0.96-1.03; P=0.686; I2=80.5%) were observed. CONCLUSIONS The prevalence of IPC was similar amongst patients undergoing TURP, HoLEP, and OP for presumed BPH. Interestingly, increased PSA level was the only independent predictor of increasing risk of IPC after BPH surgery rather than age and prostate volume. Hence, future research should focus on predictors which accurately foretell the progression of prostate cancer to determine the optimal treatment for managing patients with IPC after BPH surgery.
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Affiliation(s)
- Zhenlang Guo
- The Second Affiliated Hospital of Guangzhou University of Chinese MedicineDepartment of UrologyGuangzhouChinaDepartment of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Junwei He
- The Second Affiliated Hospital of Guangzhou University of Chinese MedicineDepartment of UrologyGuangzhouChinaDepartment of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lijuan Huang
- The First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Organ TransplantGuangzhouChinaDepartment of Organ Transplant, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Zhaohui Wang
- The Second Affiliated Hospital of Guangzhou University of Chinese MedicineDepartment of UrologyGuangzhouChinaDepartment of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ping Hu
- The Second Affiliated Hospital of Guangzhou University of Chinese MedicineDepartment of UrologyGuangzhouChinaDepartment of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shusheng Wang
- The Second Affiliated Hospital of Guangzhou University of Chinese MedicineDepartment of UrologyGuangzhouChinaDepartment of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zunguang Bai
- The Second Affiliated Hospital of Guangzhou University of Chinese MedicineDepartment of UrologyGuangzhouChinaDepartment of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jun Pan
- The Second Affiliated Hospital of Guangzhou University of Chinese MedicineDepartment of UrologyGuangzhouChinaDepartment of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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Guo Z, He J, Pan J, Huang L, Cao J, Bai Z, Wang S, Xiang S, Gu C, Wang Z. Prevalence and risk factors for incidental prostate cancer in patients after transurethral resection of the prostate with negative results on prostate biopsy: A retrospective study. Investig Clin Urol 2022; 63:201-206. [PMID: 35244994 PMCID: PMC8902422 DOI: 10.4111/icu.20210415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/19/2021] [Accepted: 12/23/2021] [Indexed: 11/18/2022] Open
Affiliation(s)
- Zhenlang Guo
- Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Junwei He
- Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jun Pan
- Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lijuan Huang
- Department of Organ Transplant, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jiadong Cao
- Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zunguang Bai
- Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shusheng Wang
- Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Songtao Xiang
- Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chiming Gu
- Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhaohui Wang
- Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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Kizilkan Y, Eroglu U, Senel S, Yildizhan M, Balci M, Aykanat IC, Aktas BK, Bulut S, Guzel O, Gokkaya CS, Aslan Y, Ozden C, Tuncel A. Evaluation of factors associated with the detection of incidental prostate cancer after open prostatectomy for benign prostatic hyperplasia. Andrologia 2021; 54:e14261. [PMID: 34590345 DOI: 10.1111/and.14261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 01/02/2023] Open
Abstract
We aimed to evaluate the incidental prostate cancer (PCa) rate and predictive factors in patients who underwent open prostatectomy (OP) with a pre-diagnosis of benign prostatic hyperplasia (BPH). This study included patients with a pre-diagnosis of BPH, who underwent OP due to symptomatic prostate enlargement. Our database included age, medications, prostate-specific antigen (PSA), free/total PSA ratio, PSA density, digital rectal examination (DRE), prostate volume, serum neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, aspartate aminotransferase/alanine aminotransferase ratio, presence of metabolic syndrome (MetS) and histopathological results after OP. Of the 430 patients that underwent OP, 406 (94.4%) with a benign pathological diagnosis were evaluated as the benign group and 24 (5.6%) detected to have PCa constituted the incidental PCa group. The rate of incidental PCa was much higher in the elderly patients. The cut-off value of age was 71.5 years in the PCa group according to the receiver operating characteristic curve analysis. According to the multivariate analysis, DRE and the presence of MetS were effective in predicting PCa (p < .001 and p = .031, respectively). DRE was found 16 times more effective and MetS was 2.8 times more effective than the other parameters. Our results showed that DRE and the presence of MetS could be useful predictive factors of incidental PCa in OP.
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Affiliation(s)
| | - Unsal Eroglu
- Department of Urology, Ankara City Hospital, Ankara, Turkey
| | - Samet Senel
- Department of Urology, Ankara City Hospital, Ankara, Turkey
| | | | - Melih Balci
- Department of Urology, Ankara City Hospital, Ankara, Turkey
| | | | | | - Suleyman Bulut
- Department of Urology, Ankara City Hospital, Ankara, Turkey
| | - Ozer Guzel
- Department of Urology, Ankara City Hospital, Ankara, Turkey
| | | | - Yilmaz Aslan
- Department of Urology, Ankara City Hospital, Ankara, Turkey
| | - Cuneyt Ozden
- Department of Urology, Ankara City Hospital, Ankara, Turkey
| | - Altug Tuncel
- Department of Urology, Ankara City Hospital, Ankara, Turkey
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Janjua TK, Yousuf MA, Iqbal MT, Memon SM, Abdullah A, Faridi N, Irfan M. Incidental finding of prostate cancer in Transurethral Resection of Prostate (TURP) specimens: a retrospective analysis from a Tertiary Care Hospital in Pakistan. Pan Afr Med J 2021; 39:20. [PMID: 34394811 PMCID: PMC8348362 DOI: 10.11604/pamj.2021.39.20.26931] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 04/29/2021] [Indexed: 11/11/2022] Open
Abstract
Introduction incidental prostate cancer findings reflect the great burden of prostatic cancer across the globe. Our 10 year retrospective analysis aimed to identify the incidence and clinic-pathologic features of prostate cancer incidentally detected in patients undergoing transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH), and to estimate the clinical value of pathologic review of all TURP specimens. Methods after excluding patients with a known diagnosis of prostate cancer prior to TURP a total of 2,386 men (ages 25-98) were identified by pathology (TURP) specimens. Yearly incidences, Gleason score, grade, pathologic stage were recorded for all incidental prostate cancer patients. Results a total of 256 (10.7%) patients were found to have prostate cancer. Mean Age was 68.51±9.22 years. T1a and T1b stage prostatic carcinoma was found in 9.9% and 90.1% of these patients respectively. Forty-nine percent (49%) patients had higher Gleason scores (>7). After subtracting average incidences between 5-year intervals, a statistical rise of almost 4% was found. Conclusion our analysis concludes that a large proportion (10.7%) of patients had incidental prostate cancer and the incidence was increasing in recent years in Pakistan and in comparison, to Asian countries. In Pakistan there is a scarcity of updated national cancer registries. The growing incidence of high Gleason scores requires keen and prompt attention. The diverse ethnic and socioeconomic background of patients propels their propensity towards loss of follow up with already limited tertiary healthcare institutes in Pakistan. This pathologic review of TURP specimens is valuable for Asiatic and non-Asiatic populations.
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Affiliation(s)
| | | | | | - Shahbaz Mustafa Memon
- Surgery Department, Sherwood Forest Hospitals, NHS Trust, Nottinghamshire, United Kingdom
| | - Aziz Abdullah
- Urology Department, Liaquat National Hospital, Karachi, Pakistan
| | - Naveen Faridi
- Pathology Department, Liaquat National Hospital, Pakistan
| | - Muhammad Irfan
- Biostatistics Department, Liaquat National Hospital, Karachi, Pakistan
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5
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Tonyali S, Ceylan C, Aglamis E, Dogan S, Tastemur S, Karaaslan M. Is there a PSA cut-off value indicating incidental prostate cancer in patients undergoing surgery for benign prostatic hyperplasia? ACTA ACUST UNITED AC 2021; 93:31-34. [PMID: 33754606 DOI: 10.4081/aiua.2021.1.31] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 12/01/2020] [Indexed: 11/22/2022]
Abstract
AIM To investigate incidental prostate cancer (IPCa) rate and to determine prostate specific antigen (PSA) cut-off value indicating PCa in patients who underwent surgery by being diagnosed with benign prostatic hyperplasia (BPH) clinically or by standard prostate biopsy. METHODS Data of 317 patients, who underwent transurethral resection of the prostate (TURP) or open prostatectomy (OP) with pre-diagnosis of BPH, were evaluated retrospectively. The examined parameters included patients' demographics, preoperative serum PSA values, digital rectal examination (DRE) findings, surgical method, histopathological findings and Gleason Scores. RESULTS A total of 317 patients were included the study. The median age of patients was 69 years (min: 51-max: 79) and the median PSA value was 3.24 ng/dl (min: 0.17-max: 34.9). In 21 patients (6.6%); DRE findings were in favor of malignancy, but prostate biopsy resulted as BPH. While 281 (88.6%) of the patients underwent TURP, 36 (11.4%) underwent open prostatectomy. PCa was detected in 21 (6.6%) patients. PSA was statistically higher in patients who underwent OP compared to patient who underwent TUR-P, 5.9 (min: 1.2 - max: 27.6, IR: 8.7) vs. 2.8 (min: 0.1-max: 34.9, IR: 4.2) ng/dl, p < .001. The rate of IPCa among four PSA group was similar (p = 0.46). There was no difference between the rate of IPCa in patients younger and older than 70 years, (p = 0.11). Please change whole sentence as 'The median PSA level was slightly higher in patients diagnosed with BPH compared to patients diagnosed with IPCa, 3.2 (min: 0.1-max: 34.9) vs. 2.7 (min: 0.3-max: 26.5) ng/dL, p = 0.9. CONCLUSIONS IPCa still remains an important clinical problem. We were not able to find any correlation of PSA and age with incidental PCa.
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Affiliation(s)
- Senol Tonyali
- Department of Urology, Istanbul University Istanbul School of Medicine, Istanbul.
| | - Cavit Ceylan
- Department of Urology, University of Health Sciences, Ankara City Hospital, Ankara.
| | - Erdogan Aglamis
- Department of Urology, University of Health Sciences, Elazig City Hospital, Elazig.
| | - Serkan Dogan
- Department of Urology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul.
| | - Sedat Tastemur
- Department of Urology, University of Health Sciences, Ankara City Hospital, Ankara.
| | - Mustafa Karaaslan
- Department of Urology, University of Health Sciences, Ankara City Hospital, Ankara.
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Pan CY, Wu B, Yao ZC, Zhu XQ, Jiang YZ, Bai S. Role of Hiraoka's transurethral detachment of the prostate combined with biopsy of the peripheral zone during the same session in patients with repeated negative biopsies in the diagnosis of prostate cancer. World J Clin Cases 2020; 8:2219-2226. [PMID: 32548152 PMCID: PMC7281050 DOI: 10.12998/wjcc.v8.i11.2219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/26/2020] [Accepted: 04/24/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Persistent suspicion of prostate cancer (PCa) due to a rising prostate-specific antigen (PSA) level after repeated negative biopsies is a serious challenge in clinical practice.
AIM To determine the role of Hiraoka’s transurethral detachment of the prostate (TUDP) combined with biopsy of the peripheral zone during the same session in patients with repeated negative biopsies in the diagnosis of PCa.
METHODS We retrospectively evaluated the records of 10 patients who were eligible for inclusion in our hospital between December 2012 and August 2017. Patient demographics, a family history of PCa, the number of biopsies, prostate volume, pathological examination, and perioperative PSA level were obtained.
RESULTS Two of 10 patients were pathologically diagnosed with PCa after surgery; the Gleason scores were 4 + 4 and 4 + 3, respectively. Both patients subsequently underwent laparoscopic radical prostatectomy. The median PSA levels preoperatively, and 3 mo and 1 year postoperatively in the other eight patients who were diagnosed with benign prostate hyperplasia after surgery were 19.10 ng/mL, 1.10 ng/mL, and 1.15 ng/mL, respectively. The adjusted P values of the 3-mo and 1-year post-operative PSA level vs pre-operative PSA level were 0.003 and 0.026, respectively. None of the patients had increased PSA levels or PCa detected after a median 35 mo of follow-up.
CONCLUSION TUDP combined with peripheral zone biopsy may improve the detection rate of PCa in patients with repeated negative biopsies. The PSA level declined rapidly in patients who had negative pathological examinations after TUDP, which remained stable 1 year after surgery.
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Affiliation(s)
- Chun-Yu Pan
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Bin Wu
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Zi-Chuan Yao
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Xian-Qing Zhu
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Yun-Zhong Jiang
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Song Bai
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
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7
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Abedi AR, Ghiasy S, Fallah-Karkan M, Rahavian A, Allameh F. The Management of Patients Diagnosed with Incidental Prostate Cancer: Narrative Review. Res Rep Urol 2020; 12:105-109. [PMID: 32215268 PMCID: PMC7083625 DOI: 10.2147/rru.s245669] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 03/02/2020] [Indexed: 12/12/2022] Open
Abstract
5–14% of patients underwent surgery for benign prostate hyperplasia harboring prostate cancer (PCa) focus. The best management of incidental prostate cancer (iPCa) has been debated. The decision “treatment or no treatment” should be determined by predictors which accurately foretell PCa progression after transurethral resection of the prostate (TURP). The purpose of this study is to review the available data that can be useful in daily clinical judgment. Transrectal ultrasound prostate biopsy (TRUSBx) did not provide further Gleason score (GS) data in most patients diagnosed with iPCa. TRUSBX may be useful before active surveillance, but not in all following radical prostatectomy. The decision “treatment or no treatment” should be dependent on the expected chance of having residual cancer and clinical progression. Prostate-specific antigen (PSA) levels before and after TURP are good predictors of residual cancer after TURP. Pathological report of T0 is most likely seen in patients with low PSA density after TURP and indistinguishable lesion on multiparametric magnetic resonance imaging. The decision “treatment vs no treatment” is judged by life expectancy, tumor characteristic in the pathology report of TURP sample and PSA level following TURP. Active surveillance should be contemplated in patients with iPCa who have both prostate-specific antigen density ≤0.08 after TURP and indistinguishable cancer lesion on multiparametric magnetic resonance imaging. Patients who do not meet the criteria for active surveillance are candidates for radical prostatectomy or radiotherapy (RT). Radical prostatectomy could be peacefully done after TURP with somewhat greater morbidity. RT in patients who had a history of TURP could be safely done and is associated with acceptable quality of life.
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Affiliation(s)
- Amir Reza Abedi
- Urology Department, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saleh Ghiasy
- Urology Department, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Morteza Fallah-Karkan
- Urology Department, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Center of Excellence for Training Laser Applications in Medicine, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Ministry of Health, Tehran, Iran
| | - Amirhossein Rahavian
- Urology Department, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Infertility and Reproductive Health Research Center (irhrc), Shahid Beheshti Medical Science University, Tehran, Iran
| | - Farzad Allameh
- Urology Department, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Center of Excellence for Training Laser Applications in Medicine, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Ministry of Health, Tehran, Iran
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8
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Porcaro AB, Tafuri A, Inverardi D, Amigoni N, Sebben M, Pirozzi M, Processali T, Rizzetto R, Shakir A, Cerrato C, Tiso L, Panunzio A, DE Michele M, Brunelli M, Siracusano S, Artibani W. Incidental prostate cancer after transurethral resection of the prostate: analysis of incidence and risk factors in 458 patients. Minerva Urol Nephrol 2020; 73:471-480. [PMID: 32003204 DOI: 10.23736/s2724-6051.19.03564-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this study is to evaluate the incidence and risk factors of incidental prostate cancer (IPCA) in a contemporary cohort of lower urinary tract symptoms (LUTS) patients who underwent trans-urethral resection of the prostate (TURP). METHODS A series of 458 consecutive patients who underwent TURP were evaluated between January 2016 to June 2018. Evaluated factors included age (years), Body Mass Index (BMI; kg/square meters), treatment with inhibitors of 5-alpha reductase, previous prostate biopsies, basal prostate specific antigen (PSA) levels (ng/mL), serum leukocyte count (×109/L), weight of resected prostate tissue (grams), grade and stage of IPCA. The multivariate logistic regression model evaluated associations of significant clinical factors with the risk of IPCA. RESULTS Overall, IPCA was detected in 30 of 454 patients (6.6%). A mean of 21.8 g of tissue was resected. The mean number of positive chips was 5.6 (mean percentage 3.9%) with tumor grade group 1 in 22 cases (73.4%) and tumor stage cT1a in 23 patients (76.7%). On multivariate analysis, independent factors that were positively associated with the risk of IPCA were BMI (odds ratio, OR=1.121; P=0.017) and leukocyte count (OR=1.144; P=0.027). CONCLUSIONS In a contemporary cohort of patients undergoing TURP for the treatment of LUTS, the risk of IPCA was not negligible with a rate of being 6.6%. BMI and serum leukocyte count were found to be independent factors that were positively associated with the risk of IPCA.
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Affiliation(s)
- Antonio B Porcaro
- Department of Urology, Verona University Hospital, University of Verona, Verona, Italy -
| | - Alessandro Tafuri
- Department of Urology, Verona University Hospital, University of Verona, Verona, Italy.,Department of Urology, USC Institute of Urology and Catherine and Joseph Aresty, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA
| | - Davide Inverardi
- Department of Urology, Verona University Hospital, University of Verona, Verona, Italy
| | - Nelia Amigoni
- Department of Urology, Verona University Hospital, University of Verona, Verona, Italy
| | - Marco Sebben
- Department of Urology, Verona University Hospital, University of Verona, Verona, Italy
| | - Marco Pirozzi
- Department of Urology, Verona University Hospital, University of Verona, Verona, Italy
| | - Tania Processali
- Department of Urology, Verona University Hospital, University of Verona, Verona, Italy
| | - Riccardo Rizzetto
- Department of Urology, Verona University Hospital, University of Verona, Verona, Italy
| | - Aliasger Shakir
- Department of Urology, USC Institute of Urology and Catherine and Joseph Aresty, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA
| | - Clara Cerrato
- Department of Urology, Verona University Hospital, University of Verona, Verona, Italy
| | - Leone Tiso
- Department of Urology, Verona University Hospital, University of Verona, Verona, Italy
| | - Andrea Panunzio
- Department of Urology, Verona University Hospital, University of Verona, Verona, Italy
| | - Mario DE Michele
- Department of Urology, Verona University Hospital, University of Verona, Verona, Italy
| | - Matteo Brunelli
- Department of Pathology, Verona University Hospital, University of Verona, Verona, Italy
| | - Salvatore Siracusano
- Department of Urology, Verona University Hospital, University of Verona, Verona, Italy
| | - Walter Artibani
- Department of Urology, Verona University Hospital, University of Verona, Verona, Italy
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9
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Sagen E, Hedelin H, Nelzén O, Peeker R. Defining and discriminating responders from non-responders following transurethral resection of the prostate. Scand J Urol 2019; 52:437-444. [DOI: 10.1080/21681805.2018.1536677] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Erik Sagen
- Department of Urology, Hospital of Skaraborg, Skövde, Sweden
- Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Hans Hedelin
- Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Olle Nelzén
- Research and Development Centre, Hospital of Skaraborg, Skövde, Sweden
| | - Ralph Peeker
- Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Sweden
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10
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Capogrosso P, Capitanio U, Vertosick EA, Ventimiglia E, Chierigo F, Oreggia D, Moretti D, Briganti A, Vickers AJ, Montorsi F, Salonia A. Temporal Trend in Incidental Prostate Cancer Detection at Surgery for Benign Prostatic Hyperplasia. Urology 2018; 122:152-157. [PMID: 30138683 DOI: 10.1016/j.urology.2018.07.028] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 07/14/2018] [Accepted: 07/17/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To assess changes in the rate of incidental prostate cancer (PCa) after benign prostatic hyperplasia (BPH) surgery over the last decade. MATERIALS AND METHODS We identified 1177 patients surgically treated for BPH (open prostatectomy, transurethral resection or holmium laser enucleation [HoLEP] of the prostate) in 2007-2016 at a single European academic center. Local polynomial regression was used to explore changes in the rate of incidental PCa detected after BPH surgery and of preoperative biopsy performed over time. Logistic regression analyses tested the association of incidental PCa diagnosis with year of surgery and preoperative biopsy. RESULTS Incidental PCa was found in 6.4% (74) of cases, 67 (91%) with Grade group 1 disease. We observed an increased incidence of PCa diagnosis after BPH surgery over time (odds ratio [OR]: 1.12; 95%confidence interval [CI]: 1.02-1.24, P = .02) along with a concomitant decrease in the rate of preoperative prostate biopsies (OR: 0.83; 95%CI: 0.79-0.88, P < .0001). Patients undergoing a preoperative biopsy showed a lower risk of being diagnosed with PCa after surgery (OR: 0.29; 95% CI: 0.12, 0.72 P = .007). Patients treated with HoLEP had a higher chance of incidental PCa detection (OR: 2.28; 95%CI: 1.30-4.00; P = .004), although this may be related to the significantly higher number of HoLEP performed over the last years. CONCLUSION The increased rate of low-risk PCa detected after BPH surgery in the last decade reflects the clinical practice changes in PCa screening and diagnosis leading to a reduced number of unnecessary biopsies and indolent cancer diagnosis.
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Affiliation(s)
- Paolo Capogrosso
- Università Vita-Salute San Raffaele, Milan, Italy; Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.
| | - Umberto Capitanio
- Università Vita-Salute San Raffaele, Milan, Italy; Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - Eugenio Ventimiglia
- Università Vita-Salute San Raffaele, Milan, Italy; Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Francesco Chierigo
- Università Vita-Salute San Raffaele, Milan, Italy; Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Davide Oreggia
- Università Vita-Salute San Raffaele, Milan, Italy; Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Donatella Moretti
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Alberto Briganti
- Università Vita-Salute San Raffaele, Milan, Italy; Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - Francesco Montorsi
- Università Vita-Salute San Raffaele, Milan, Italy; Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Andrea Salonia
- Università Vita-Salute San Raffaele, Milan, Italy; Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
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11
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Zhang B, Wei J, Wu X, Wang L, Huo H, Wang J. Clinical optimal dose of solifenacin succinate for nursing patients after transurethral resection of the prostate during the perioperative period. Exp Ther Med 2018; 15:1660-1665. [PMID: 29434751 DOI: 10.3892/etm.2017.5567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 04/21/2017] [Indexed: 02/02/2023] Open
Abstract
Transurethral plasma kinetic resection is an efficient and safe surgery for the treatment of benign prostatic hyperplasia. Solifenacin succinate (SOL) is safe and clinically efficient for patients who endure transurethral resection of the prostate (TURP) during the perioperative period. The objective of this study was to evaluate the clinical optimal dose of SOL for nursing patients after TURP during the perioperative period. Patients were recruited and randomized into three groups: SOL (3 mg), SOL (6 mg), and SOL (10 mg). All patients received medical care for 3 weeks after TURP. Levels of inflammatory cytokines, including IL-6, epithelial neutrophil activation peptide-7 (ENA-7), tumor necrosis factor (TNF)-α, interleukin (IL)-2, IL-17 and IL-8, were investigated in the patients of all three groups. The efficacy of SOL was analyzed via the following scores: International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score (OBSS), short-form voiding (SFV) and storage score (TS) of International Continence Society (ICS). Outcomes showed that IL-2 and ENA-7 plasma concentration levels were upregulated, whereas TNF-α, IL-6, IL-17 and IL-8 were downregulated, in all three groups. The findings showed that patients that received SOL (6 mg) exhibited significant improvements compared to the other patient groups from baseline to the end of treatment, as determined by IPSS, OBSS, ICS, SFV, TS (P<0.01). In conclusion, these results indicate that SOL (6 mg) is the optimal dose for patients who undergo TURP during the perioperative period. Notably, treatment with SOL (6 mg) exhibited significant additional benefits in terms of lower urinary tract symptoms during the early recovery period after TURP, suggesting SOL is clinically significant for nursing patients who suffer have undergone TURP during the perioperative period.
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Affiliation(s)
- Baodi Zhang
- Department of Surgery, First Branch of Hongqi Hospital of Mudanjiang Medical University, Mudanjiang, Heilongjiang 157011, P.R. China
| | - Jia Wei
- Department of Surgery, First Branch of Hongqi Hospital of Mudanjiang Medical University, Mudanjiang, Heilongjiang 157011, P.R. China
| | - Xuan Wu
- Dialysis Room, First Branch of Hongqi Hospital of Mudanjiang Medical University, Mudanjiang, Heilongjiang 157011, P.R. China
| | - Lei Wang
- Department of Surgery, First Branch of Hongqi Hospital of Mudanjiang Medical University, Mudanjiang, Heilongjiang 157011, P.R. China
| | - Hongdan Huo
- Department of Surgery, First Branch of Hongqi Hospital of Mudanjiang Medical University, Mudanjiang, Heilongjiang 157011, P.R. China
| | - Junrong Wang
- Operating Room, First Branch of Hongqi Hospital of Mudanjiang Medical University, Mudanjiang, Heilongjiang 157011, P.R. China
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12
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Abedi AR, Fallah-Karkan M, Allameh F, Ranjbar A, Shadmehr A. Incidental prostate cancer: a 10-year review of a tertiary center, Tehran, Iran. Res Rep Urol 2018; 10:1-6. [PMID: 29392121 PMCID: PMC5768285 DOI: 10.2147/rru.s146159] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Objective Incidental prostate cancer (IPCa) is defined as a symptom-free cancer unexpectedly discovered upon microscopic examination of resected tissue. The aim of this study was to report the correlation between some specific clinical criteria in patients incidentally diagnosed with prostate cancer (PCa) during transurethral resection of the prostate (TURP) or open prostatectomy (OP) after clinically suspected benign prostatic hyperplasia. Patients and methods This was a cross-sectional, retrospective study. Data were collected from Shohada-e-Tajrish Hospital database during November 2006 to October 2016. Four hundred and twenty three men suffering from symptomatic benign prostatic hyperplasia who underwent either TURP or OP that provided a prostate specimen were evaluated. The data analysis was performed using Pearson correlation test and independent t-test using SPSS version 20 software. Results The mean age of subjects was 68.74±9.87 years old (45-93 years). The mean prostate specific antigen (PSA) level was 21.47±13.44 ng/mL (0.6-47.1 ng/mL). Results showed that 84 patients (19.9%) had PCa (40 patients who underwent TURP [12.6%] and 44 patients who underwent OP [40.7%] groups). Cut-off point of PSA for detecting IPCa was 3.8 ng/mL in our study, and this showed sensitivity, specificity, negative predictive value, and positive predictive value of 26.08%, 100%, 100%, and 29.79%, respectively. Twenty two patients with cancer had a positive family history for PCa; thus, a significant relationship between familial history of PCa and its occurrence was shown (p=0.0001). Conclusion According to the results of this study, the cut-off point for PSA levels in detecting PCa was 3.8 ng/mL, which is similar to that reported by other studies. Familial history of PCa and PSA levels were two predictors in determining the PCa.
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Affiliation(s)
- Amir-Reza Abedi
- Urology Department, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Morteza Fallah-Karkan
- Urology Department, Shohada-e-Tajrish Hospital, Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Allameh
- Urology Department, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arash Ranjbar
- Urology Department, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Afshin Shadmehr
- Urology Department, Isfahan University of Medical Sciences, Isfahan, Iran
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13
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Varghese J, Kuruvilla PM, Mehta N, Rathore RS, Babu M, Bansal D, Pillai B, Sam MP, Krishnamorthy H. Incidentally Detected Adenocarcinoma Prostate in Transurethral Resection of Prostate Specimens: a Hospital Based Study from India. Asian Pac J Cancer Prev 2017; 17:2255-8. [PMID: 27221926 DOI: 10.7314/apjcp.2016.17.4.2255] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Awareness about prostate cancer has increased in the community, and prostate cancer screening examinations, including prostate specific antigen (PSA) assays, are now widely available. Prior to the PSA era, up to 27% of prostate cancers were detected incidentally at the time of transurethral resection of prostate (TURP). After PSA testing became widely available, the incidence of incidentally detected carcinoma prostate in TURP specimens without prior diagnosis reduced to 5-13%. However, the incidence of incidentally detected carcinoma prostate has been reported to vary across the globe since various factors can influence the identification of this malignancy in TURP specimens. In this paper, we focus on rates of incidentally detected prostate cancer in TURP specimens in our hospital and correlate it with various parameters. MATERIALS AND METHODS This retrospective study of histopathological findings of biopsy specimens was conducted for patients undergoing TURP during a period of 5 years from April 2010. The inclusion criteria were patients diagnosed with benign prostatic hyperplasia (BPH) (digital rectal examination (DRE) not showing any abnormally hard areas and normal age adjusted PSA values). Patients with elevated PSA, abnormal DRE, documented urinary tract infection and proved adenocarcinoma prostate (CaP) were excluded from the study. The total weight of prostatectomy specimen, occurrence of carcinoma prostate in the chips, percentage of total tissue resected showing malignancy and Gleason's scores were recorded. RESULTS A total of 597 patients belonging to the inclusion criteria were studied. The incidence of occult CaP in the study group was 5.2 % (31/597). Out of these, 8 belonged to T1a and 23 belonged to T1b stages. The age group 70 - 79 years had the maximum incidence of occult CaP. It was observed that the clinical grading of prostate did not have a bearing on the incidence of occult CaP whereas the weight of resected specimen correlated with the incidence of CaP. The incidence of occult CaP was greater with low volume prostates (<20 g). (P=0.15). CONCLUSIONS The rate of incidentally detected adenocarcinoma prostate in patients undergoing TURP for clinically diagnosed BPH was found to be only 5.2 % in our study which is low when compared with similar studies done elsewhere. The age of the patient and weight of the resected specimen correlated with incidence of occult prostate cancer. The clinical grading of prostate by DRE however, demonstrated no correlation.
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Affiliation(s)
- Jophy Varghese
- Department of Pathology, Lourdes Hospital, Cochin, Kerala, India E-mail :
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14
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Perera M, Lawrentschuk N, Perera N, Bolton D, Clouston D. Incidental prostate cancer in transurethral resection of prostate specimens in men aged up to 65 years. Prostate Int 2015; 4:11-4. [PMID: 27014658 PMCID: PMC4789333 DOI: 10.1016/j.prnil.2015.10.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 09/25/2015] [Accepted: 10/28/2015] [Indexed: 11/10/2022] Open
Abstract
Background The identification of prostate cancer (PC) is important in men aged ≤ 65 years. We examined complete transurethral resection of prostate (TURP) specimens to quantify the incidence and nature of PC in men aged ≤ 65 years. Methods A prospective multi-institutional database included TURP specimens. The cohort was stratified into two groups according to age. For men aged ≤ 65 years, the entire specimen was submitted for histological analysis, while the TURP specimens from men aged > 65 years were sampled following standard guidelines. Results A total of 923 men were included, with 224 in the younger group. PC was identified in 13.4% in men aged ≤ 65 years, compared with 28.7% the older group. The younger group had a lower proportion of Gleason score ≥ 7 (30% compared with 40%) and higher rates of pT1a (57% compared with 43%). In men aged ≤ 65 years with cancer, tumor was identified in one block in 15 of 30 cases (50%). Following diagnosis, 4/30 underwent radical prostatectomy, 5/30 underwent curative radiotherapy, 10/30 androgen deprivation, and 1/30 received palliative radiotherapy. Conclusion Incidental PC in men aged ≤ 65 years is not uncommon. Our results suggest that TURP specimens in men aged ≤ 65 years should be completely assessed. Underidentification of cancer may occur as a result of increasing use of laser prostatectomy and the consequent loss of tissue for pathological examination.
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Affiliation(s)
- Marlon Perera
- School of Medicine, University of Queensland, St Lucia, QLD, Australia; Department of Surgery, University of Melbourne, VIC, Australia
| | - Nathan Lawrentschuk
- Department of Surgery, University of Melbourne, VIC, Australia; Ludwig Institute for Cancer Research, Austin Hospital, Heidelberg, VIC, Australia; Department of Urology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Nayomi Perera
- Department of Surgery, University of Melbourne, VIC, Australia
| | - Damien Bolton
- Department of Surgery, University of Melbourne, VIC, Australia; Ludwig Institute for Cancer Research, Austin Hospital, Heidelberg, VIC, Australia
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Sakamoto H, Matsumoto K, Hayakawa N, Maeda T, Sato A, Ninomiya A, Mukai K, Nakamura S. Preoperative parameters to predict incidental (T1a and T1b) prostate cancer. Can Urol Assoc J 2014; 8:E815-20. [PMID: 25485009 PMCID: PMC4250246 DOI: 10.5489/cuaj.1890] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTON Prostate cancer has been found incidentally in transurethral resection of the prostate (TURP) specimens without prior diagnosis in 5% to 13% of the patients. We evaluated whether incidental prostate cancer (stages T1a and T1b) could be predicted preoperatively. METHODS TURP was performed in 307 patients between 2006 and 2011. Patient age, prostate-specific antigen (PSA) level, total prostate volume, transitional zone volume, PSA density, history of needle biopsy, and pathological diagnosis on TURP specimen were assessed. We analyzed the association between these parameters and prostate cancer detection. RESULTS Incidental prostate cancer was found in 31 patients (10.1%), and 13 cases (4.2%) had cancer with T1b and/or Gleason ≥7. Multivariate analysis demonstrated that age ≥75 years (odds ratio [OR] 2.58, p = 0.022), prostate volume ≤50 cc (OR 4.11, p < 0.001), and the absence of preoperative needle biopsy despite PSA ≥4 ng/mL (OR 2.65, p = 0.046) were independent risk factors. In patients who had 2 or 3 of these risk factors, incidental prostate cancer and cancer with T1b and/or Gleason ≥7 were observed in 25% to 50% and 16% to 25% cases, respectively. CONCLUSIONS Older patient age, small prostate volume, and the absence of previous needle biopsy (despite a high PSA level) might be independent risk factors for detecting incidental prostate cancer, although external validation is warranted to confirm our results.
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Affiliation(s)
- Hirofumi Sakamoto
- Tokyo Saiseikai Central Hospital, Department of Urology, Minato-ku, Tokyo, Japan
| | - Kazuhiro Matsumoto
- Tokyo Saiseikai Central Hospital, Department of Urology, Minato-ku, Tokyo, Japan
| | - Nozomi Hayakawa
- Tokyo Saiseikai Central Hospital, Department of Urology, Minato-ku, Tokyo, Japan
| | - Takahiro Maeda
- Tokyo Saiseikai Central Hospital, Department of Urology, Minato-ku, Tokyo, Japan
| | - Atsuko Sato
- Tokyo Saiseikai Central Hospital, Department of Urology, Minato-ku, Tokyo, Japan
| | - Akiharu Ninomiya
- Tokyo Saiseikai Central Hospital, Department of Urology, Minato-ku, Tokyo, Japan
| | - Kiyoshi Mukai
- Tokyo Saiseikai Central Hospital, Department of Diagnostic Pathology, Tokyo, Japan
| | - So Nakamura
- Tokyo Saiseikai Central Hospital, Department of Urology, Minato-ku, Tokyo, Japan
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Skrzypczyk MA, Dobruch J, Nyk L, Szostek P, Szempliński S, Borówka A. Should all specimens taken during surgical treatment of patients with benign prostatic hyperplasia be assessed by a pathologist? Cent European J Urol 2014; 67:227-32. [PMID: 25247076 PMCID: PMC4165677 DOI: 10.5173/ceju.2014.03.art2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 04/07/2014] [Accepted: 05/31/2014] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION In some patients submitted to transurethral resection of the prostatic (TURP) or prostatectomy (OAE) due to benign prostate hyperplasia (BPH), pathological evaluations (PE) revealed coexistence of prostate cancer (PCa) and BPH. The aim of the study is to evaluate the incidence of PCa diagnosed incidentally in prostate specimens taken during BPH surgery, to assess the need of routine PE and to define the group of patients in whom PE could be abandoned without the risk of omitting clinically significant PCa. MATERIAL AND METHODS 968 consecutive men were subjected to surgical treatment due to BPH in Jan. 2004-Sep. 2010. RESULTS 823 (85%) underwent TURP and 145 (15%) OAE. Incidental (Inc) PCa was diagnosed in 34(3.5%) pts. T1a and T1b stages were determined in 19 (2%) and 15 (1.5%) cases. Preoperative prostate biopsy due to abnormal prostate specific antigen (PSA) or digital rectal exam (DRE) was performed in 85 (8.8%) pts. Of PCa pts, 7 (20.58%) had undergone a cancer negative biopsy preoperatively. In BPH pts, 78 (8.35%) had undergone a prostate biopsy previously (p <0.01). Univariate and logit regression analyses had not revealed any correlations between age, Pv, serum PSA and frequency of IncPCa. The difference in rate of PCa diagnosed in patients with PSAD ≥0.15 and <0.15 was 8 pts (14.04%) and 20 pts (4.05%), respectively (p <0.001). Gls in those pts was >6 only in 4 cases. CONCLUSIONS Despite the fact of low PCa detection rate observed in our study, this condition was clinically relevant in 15 (1.5%) subjects. It is difficult to establish any cut off values of pts' age, Pv, serum PSA level suggestive of negligible risk for prostate cancer.
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Affiliation(s)
| | - Jakub Dobruch
- Centre of Postgraduate Medical Education in Warsaw, Poland
| | - Lukasz Nyk
- Centre of Postgraduate Medical Education in Warsaw, Poland
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Incidental prostate cancer in transurethral resection of the prostate specimens in the modern era. Adv Urol 2014; 2014:627290. [PMID: 24876835 PMCID: PMC4022114 DOI: 10.1155/2014/627290] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 04/12/2014] [Indexed: 02/08/2023] Open
Abstract
Objectives. To identify rates of incidentally detected prostate cancer in patients undergoing surgical management of benign prostatic hyperplasia (BPH). Materials and Methods. A retrospective review was performed on all transurethral resections of the prostate (TURP) regardless of technique from 2006 to 2011 at a single tertiary care institution. 793 men (ages 45-90) were identified by pathology specimen. Those with a known diagnosis of prostate cancer prior to TURP were excluded (n = 22) from the analysis. Results. 760 patients had benign pathology; eleven (1.4%) patients were found to have prostate cancer. Grade of disease ranged from Gleason 3 + 3 = 6 to Gleason 3 + 4 = 7. Nine patients had cT1a disease and two had cT1b disease. Seven patients were managed by active surveillance with no further events, one patient underwent radiation, and three patients underwent radical prostatectomy. Conclusions. Our series demonstrates that 1.4% of patients were found to have prostate cancer, of these 0.5% required treatment. Given the low incidental prostate cancer detection rate, the value of pathologic review of TURP specimens may be limited depending on the patient population.
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