Evaluation of factors associated with the detection of incidental prostate cancer after open prostatectomy for benign prostatic hyperplasia

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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Incidental Prostate Cancer and Its Characteristics in Patients Undergoing Open Prostatectomy Due to Benign Prostatic Hyperplasia

Bakirkoy Tip Dergisi / Medical Journal of Bakirkoy ◽

10.4274/btdmjb.galenos.2018.20181219031450 ◽

2019 ◽

Vol 15 (1) ◽

pp. 87-90 ◽

Cited By ~ 1

Author(s):

Ekrem Güner ◽

Kamil Gökhan Şeker

Keyword(s):

Prostate Cancer ◽

Benign Prostatic Hyperplasia ◽

Prostatic Hyperplasia ◽

Open Prostatectomy ◽

Incidental Prostate Cancer

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PSCA mRNA expression in preoperatively negative prostate biopsies predicts incidental prostate cancer in patients undergoing transurethral resection of the prostate for benign prostatic hyperplasia

Journal of Surgical Oncology ◽

10.1002/jso.21996 ◽

2011 ◽

Vol 104 (6) ◽

pp. 672-678 ◽

Cited By ~ 4

Author(s):

Zhigang Zhao ◽

Wenjing Ma ◽

Guohua Zeng ◽

Defeng Qi

Keyword(s):

Prostate Cancer ◽

Benign Prostatic Hyperplasia ◽

Mrna Expression ◽

Transurethral Resection ◽

Prostatic Hyperplasia ◽

Incidental Prostate Cancer ◽

Prostate Biopsies

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Temporal Trend in Incidental Prostate Cancer Detection at Surgery for Benign Prostatic Hyperplasia

Urology ◽

10.1016/j.urology.2018.07.028 ◽

2018 ◽

Vol 122 ◽

pp. 152-157 ◽

Cited By ~ 5

Author(s):

Paolo Capogrosso ◽

Umberto Capitanio ◽

Emily A. Vertosick ◽

Eugenio Ventimiglia ◽

Francesco Chierigo ◽

...

Keyword(s):

Prostate Cancer ◽

Benign Prostatic Hyperplasia ◽

Cancer Detection ◽

Temporal Trend ◽

Prostatic Hyperplasia ◽

Incidental Prostate Cancer ◽

Prostate Cancer Detection

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Incidence of incidental cancer in transurethral resection of prostate specimens: a 10-year retrospective analysis

African Journal of Urology ◽

10.1186/s12301-021-00219-w ◽

2021 ◽

Vol 27 (1) ◽

Author(s):

Döndü Nergiz ◽

Hülya Tosun Yıldırım ◽

Şenay Yıldırım

Keyword(s):

Prostate Cancer ◽

Benign Prostatic Hyperplasia ◽

Cancer Detection ◽

Transurethral Resection ◽

Prostatic Hyperplasia ◽

Clinicopathological Parameters ◽

Incidental Prostate Cancer ◽

Prostate Cancer Detection ◽

Cancer Group ◽

Significant Difference

Abstract Background Prostate cancer can be detected incidentally in patients undergoing transurethral resection of the prostate for benign prostatic hyperplasia. Therefore, it is very important that the transurethral resection of the prostate specimen is evaluated carefully for accurate grading and staging. The aim of this study was to investigate the frequency of incidental prostate cancer and its relationship with clinicopathological findings. Methods The study included a total of 900 patients, who underwent transurethral resection of the prostate for benign prostatic hyperplasia treatment between June 2010 and June 2020. Patient age, prostate-specific antigen (PSA) levels and resected prostate weight were assessed, and the tumor stage, Gleason grade group, lymphovascular and perineural invasion status were also evaluated in the incidental prostate cancer group. The association between these parameters and prostate cancer detection was analyzed. Results Incidental detection of prostate cancer was determined at the rate of 13.3%. The incidental prostate cancer group had a significantly higher mean age and PSA levels compared to the benign prostatic hyperplasia group. The weight of the resected specimen had no impact on the incidence of incidental prostate cancer. Of the total 120 incidental prostate cancer cases, 59 (49.2%) were stage T1a and 61 (50.8%) were stage T1b. No significant difference was determined between the T1 stages and age distribution, but a statistically significant difference was determined in the other clinicopathological parameters. Conclusions The results of this study demonstrated that the incidence of incidental prostate cancer detection was related to age and PSA levels and increased, especially in those aged ≥ 60 years and/or PSA level ≥ 4 ng/mL. To avoid overlooking incidental prostate cancer in these patients, it can be recommended that material is sufficiently sampled and carefully evaluated, and when necessary, all resected specimens are examined. Although no significant correlation was determined between specimen weight and the incidence of incidental prostate cancer, as a significant difference was determined in T1 stages, this suggests that the amount of material evaluated could change the sub-stage.

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Preoperative Clinical Factors for Diagnosis of Incidental Prostate Cancer in the Era of Tissue-Ablative Surgery for Benign Prostatic Hyperplasia: A Korean Multi-Center Review

Korean Journal of Urology ◽

10.4111/kju.2012.53.6.391 ◽

2012 ◽

Vol 53 (6) ◽

pp. 391 ◽

Cited By ~ 8

Author(s):

Changhee Yoo ◽

Cheol Young Oh ◽

Se Joong Kim ◽

Sun Il Kim ◽

Young Sig Kim ◽

...

Keyword(s):

Prostate Cancer ◽

Benign Prostatic Hyperplasia ◽

Prostatic Hyperplasia ◽

Clinical Factors ◽

Incidental Prostate Cancer ◽

Ablative Surgery

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Incidental Prostate Cancer in Radical Prostatectomy Specimens of Patients Treated for Benign Prostatic Hyperplasia (BPH): Histopathology Analysis

Journal of Global Oncology ◽

10.1200/jgo.18.57700 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 37s-37s

Author(s):

O. Oluwole

Keyword(s):

Prostate Cancer ◽

Benign Prostatic Hyperplasia ◽

Radical Prostatectomy ◽

Teaching Hospital ◽

Malignant Tumors ◽

The United States ◽

Prostatic Hyperplasia ◽

University Teaching ◽

Incidental Prostate Cancer ◽

Study Results

Background: The incidence of prostate cancer (Pca) is the first in malignant tumors among men in the United States, and mortality rate is the second cause of deaths. Incidental prostate cancer is defined as clinically inapparent tumor that is neither palpable nor visible by imaging. Incidental carcinoma is found in 3%-16% of pathology specimens of patients undergoing BPH surgery and it involves less than 5% of resected tissue. Aim: To identify incidentally detected prostate cancer in benign prostatic specimens submitted for histopathology Methods: This is a ten-year retrospective histopathology study of all prostate cancer cases diagnosed between 1991-2000 in the department of Pathology, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Haematoxylin & eosin stained histology slides were retrieved and studied. Institution review board (IRB) approval was obtained from the Teaching Hospital to undertake this study. Results: A total of 67 patients had benign prostatic hyperplasia; the patients' age ranged from 30-75 years with a mean age of 52.5 years. The peak age at diagnosis was in the fifth decade. 26 (38.8%) patients had incidental carcinoma. All the tumors were adenocarcinoma and moderately differentiated. Two patients in their fourth decade were found to have incidental prostate cancer. Conclusion: Incidental prostate cancer is common in patients' undergoing radical prostatectomy for BPH, a high index of suspicion, adequate histopathology training and histopathologic evaluation is critical to diagnosis.

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