The effect of endoscopic mucosal resection with ligation for intestinal metaplasia of Barrett′s esophagus

Abstract

Objective To explore the clinical pathological characteristics and prognostic features of incidental prostatic carcinoma after transurethral resection of prostate (TURP) and to improve the recognition in the diagnosis and treatment of incidental prostate cancer. Methods Five hundred and eighty patients who underwent TURP from Jan. 2009 to Dec. 2016 in Beijing Anzhen hospital were analyzed retrospectively. The general and clinical pathological data of patients suffer with incidental prostate cancer were collected in hospital. The age, preoperative PSA level, prostate volume and the weight of the resected prostate in two groups were compared between benign prostatic hyperplasia and incidental prostatic carcinoma; All the patients with incidental prostate cancer were divided into stage T1a and T1b group. The preoperative PSA level, prostate volume, the weight of the resected prostate, Gleason score and prognosis were compared between the two groups. Results Sixteen cases of incidental prostate cancer were detected and the detection rate of incidental prostate cancer after the TURP was 2.8% (16/580). There was no significant difference in preoperative PSA level, prostate volume and the weight of the resected prostate between the two groups of prostate hyperplasia and incidental prostate cancer; 7 cases of incidental prostate cancer patients belonged to T1a (1.2%) and 9 cases belonged to T1b (1.6%). The Gleason score in stage T1a was significantly lower than stage T1b in incidental prostate cancer patients. There was no significant difference in preoperative PSA level, F-PSA/T-PSA, prostate volume and the weight of the resected prostate between stage T1a and T1b groups. All the patients accepted maximal androgen deprivation therapy. The mean follow-up time was (50.3±25.9) months. The PSA level was decreased by 85.1% and 97.5% in stage T1a patients after there and six months after TURP, while 86.9% and 96.3% in stage T1b patients. One patient died of acute myocardial infarction in T1a incidental prostate cancer patients and one patient die of renal failure in I1b during the follow-up period. There were no cases of prostate cancer specific death. Conclusions The detection rate of incidental prostate cancer after the TURP was 2.8%, and maximal androgen deprivation therapy for incidental prostate cancer is effective and safety. Key words: Incidental prostate cancer; TURP; BPH