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.
Highlights
Clinical T1 or incidental prostate cancer is defined as clinically inapparent tumor that is neither palpable nor visible by imaging
With an increase in PSA screening, there has been a decrease in pT1a and pT1b lesions [2]
After obtaining Institutional Review Board (IRB) approval, a retrospective review was performed of all transurethral resections or enucleations of the prostate that provided a tissue specimen between 2006 and 2011. 793 men, aged from 45 to 90, were identified who underwent a transurethral procedure of the prostate that provided a specimen
Summary
Clinical T1 or incidental prostate cancer is defined as clinically inapparent tumor that is neither palpable nor visible by imaging. With an increase in PSA screening, there has been a decrease in pT1a and pT1b lesions [2]. Along with this shift in incidental prostate cancer distribution with the introduction of PSA, fewer traditional TURPs are being performed as newer techniques, such as laser vaporization, are being adopted [3]. These new technologies do not always provide tissue for pathological examination leading to potentially missed cancers. Some incidental prostate cancers have been shown to be clinically relevant, tumors with a higher Gleason score and stage pT1b [4]
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