Incidental prostate cancer after TURP or prostate adenectomy, how to proceed?

Abstract

Background: During this work we will talk about incidental prostate cancer. It is defined by the presence of cancerous cells on the anatomical pathology specimens of RTUP or adenectomy in patients initially admitted for BPH management. That is, in these patients the preoperative PSA and DRE were considered normal. There is still debate about the optimal treatment for patients with incidental prostate cancer. The objective of this research is to provide a clear challenge for care this subgroup of prostate cancer. Methods: Our study was based on pubmed data, we used the terms: incidental, prostate cancer, and TURP. Then we limited the study period to the period between 1985 and 2023. Result: We have eliminated all the articles not written in English. After we have chosen that we saw that they answer well to our subject. Discussion: In a first plan we see that the classical TNM classification that divides these patients in T1a and T1b divide these patients in a heterogeneous group of patients. Currently we can see that we can base ourselves on progression factors that allow us to divide each group of these patients into a subgroup of good prognosis and a bad prognosis, the reclassification biopsy has a place only in the active surveillance. Active surveillance is the treatment of choice for PT1a patients with a GCS of 6 or less and a life expectancy of less than 10 years, Radical prostatectomy is an optional treatment for patients with long life experience and low differentiated tumors. and is the standard treatment for T1b patients with a life expectancy of more than ten years who accept surgical complications, Radiation therapy is optional in patients with stage T1a, in patients with a life expectancy of more than 10 years and with low differentiated tumors. On the other hand, it represents the treatment of choice of t1b whose life expectancy exceeds 10 years or between 5 and 10 years with low differentiated tumors, and in these patient’s surgery is not indicated. Hormonotherapy alone is indicated only for symptomatic T1b tumors for which curative treatment is not possible, Hormonotherapy combined with radiation therapy has demonstrated local control and better global survival.