MP13-19 PROSTATE HEALTH INDEX IS ASSOCIATED WITH INCIDENTAL PROSTATE CANCER DETECTION AT TIME OF HOLMIUM LASER ENUCLEATION OF THE PROSTATE

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP13-19 PROSTATE HEALTH INDEX IS ASSOCIATED WITH INCIDENTAL PROSTATE CANCER DETECTION AT TIME OF HOLMIUM LASER ENUCLEATION OF THE PROSTATE Eric Li, Jenny Guo, Nicholas Dean, Mark Assmus, Ruoji Zhou, Ashley Ross, Matthew Lee, and Amy Krambeck Eric LiEric Li More articles by this author , Jenny GuoJenny Guo More articles by this author , Nicholas DeanNicholas Dean More articles by this author , Mark AssmusMark Assmus More articles by this author , Ruoji ZhouRuoji Zhou More articles by this author , Ashley RossAshley Ross More articles by this author , Matthew LeeMatthew Lee More articles by this author , and Amy KrambeckAmy Krambeck More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003233.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Holmium laser enucleation of the prostate (HoLEP) is a size-independent treatment option for BPH. Unfortunately, despite an appropriate work up for elevated PSA, incidental prostate cancer (iPCa) is found in up to 20% of men undergoing HoLEP. HoLEP is not a therapeutic surgical treatment for prostate cancer, so we sought to identify risk factors for iPCa at the time of HoLEP for pre-operative risk stratification. METHODS: We retrospectively queried for men undergoing HoLEP from January 2021-July 2022, and obtained clinicopathologic data. Men with prior history of prostate cancer were excluded (n=55). T test, chi-squared, Fisher’s exact test, and multivariable logistic regression were performed. RESULTS: On univariable regression, PHI >55 was a significant predictor of iPCa (OR 7.27, 95% CI 1.97-27.5, p=0.003), which remained significant on multivariable adjustment for age (OR 6.76, 95% CI 1.81-25.7, p=0.004). On univariable regression, preoperative PSA (p=0.15), % Free PSA (p=0.12), MRI prostate volume (p=0.69), PSA density (p=0.62), prior negative biopsy (p=0.31), and MRI PIRADS were not significantly associated with iPCa. Of the 39 patients who had pre-operative PIRADS 4 or 5 lesions, 36 patients had pre-operative negative biopsy, and only one patient was ultimately found to have iPCa. 66% (68/103) of iPCa was Gleason Grade Group 1 with a median of 1% of tissue positive. CONCLUSIONS: PHI>55 is an independent predictor of iPCa at time of HoLEP. To our knowledge, this is the first report of the association of PHI and iPCa. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e180 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Eric Li More articles by this author Jenny Guo More articles by this author Nicholas Dean More articles by this author Mark Assmus More articles by this author Ruoji Zhou More articles by this author Ashley Ross More articles by this author Matthew Lee More articles by this author Amy Krambeck More articles by this author Expand All Advertisement PDF downloadLoading ...