MP35-20 PREVALENCE OF INCIDENTAL PROSTATE CANCER IN HISTOLOGICAL SPECIMEN AFTER HOLMIUM LASER ENUCLEATION VERSUS TRANSURETHRAL RESECTION OF THE PROSTATE

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Epidemiology & Evaluation1 Apr 2016MP35-20 PREVALENCE OF INCIDENTAL PROSTATE CANCER IN HISTOLOGICAL SPECIMEN AFTER HOLMIUM LASER ENUCLEATION VERSUS TRANSURETHRAL RESECTION OF THE PROSTATE Annika Herlemann, Kerstin Wegner, Alexander Roosen, Christian G. Stief, Christian Gratzke, Giuseppe Magistro, and Alexander Buchner Annika HerlemannAnnika Herlemann More articles by this author , Kerstin WegnerKerstin Wegner More articles by this author , Alexander RoosenAlexander Roosen More articles by this author , Christian G. StiefChristian G. Stief More articles by this author , Christian GratzkeChristian Gratzke More articles by this author , Giuseppe MagistroGiuseppe Magistro More articles by this author , and Alexander BuchnerAlexander Buchner More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1612AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prostate cancer (PCa) is found incidentally during pathological examinations of benign prostatic hyperplasia (BPH) specimens in ~5% of patients. Our objective was to evaluate the prevalence of incidental PCa after holmium laser enucleation of the prostate (HoLEP) in comparison to transurethral resection of the prostate (TURP). METHODS All patients undergoing HoLEP or TURP for BPH in our department from January 2013 to December 2014 were retrospectively identified. All procedures were carried out by a single surgeon. A preoperative prostate biopsy was performed whenever indicated due to suspicious DRE, elevated total PSA or high PSA density. Patients who had a prior history of PCa were excluded from the analysis. We evaluated age, total PSA, prostate volume, PSA density, history of prostate biopsy, resected prostate weight, and pathological parameters. Univariate and multivariate logistic regression models were used to determine factors associated with incidental PCa. RESULTS 518 patients were included in the analysis. Mean patient age was comparable. HoLEP patients had a significantly higher preoperative total PSA (7.0 vs. 3.5; p<0.001) and prostate volume (86 vs. 47; p<0.001) compared to the TURP group. PSA density was similar in both groups. A preoperative biopsy was more frequently performed in the HoLEP group (35 vs. 15%; p<0.001). The mean percent prostate tissue resected was significantely greater in the HoLEP group compared to the TURP group (74 vs. 54%; p<0.001), however, the rate of incidental prostate cancer findings was similar (15 vs. 17%; p=n.s.). Stage T1b was more frequent in the TURP group (24 vs. 12%, p=n.s.). Distribution of Gleason score was comparable in both groups. On multivariate logistic regression, age and PSA density were independent predictors for incidental PCa. CONCLUSIONS Despite significantly higher tissue removal by HoLEP in comparison to TURP, the choice of technique has no influence on the diagnosis of incidental PCa. Older patient age and a higher PSA density are independent predictors for the detection of incidental PCa. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e488 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Annika Herlemann More articles by this author Kerstin Wegner More articles by this author Alexander Roosen More articles by this author Christian G. Stief More articles by this author Christian Gratzke More articles by this author Giuseppe Magistro More articles by this author Alexander Buchner More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...