ABSTRACT
Objective:
To determine the incidence of incidental prostate cancer and its association with prostate specific antigen (PSA) as a result of final pathological examinations of patients undergoing open prostatectomy.
Methods:
The data of 124 patients who underwent open prostatectomy between 2008 and 2018 were analyzed retrospectively. Demographic information, preoperative PSA values, transrectal prostate needle biopsy (TRIB) results, prostate size and final pathology results were analyzed.
Results:
As a result of open prostatectomy specimens, benign prostatic hyperplasia was detected in all patients and prostate adenocancer was detected in 5 (4%) and chronic prostatitis in 68 (54.8%) patients. All patients with prostate cancer had preoperative TRIB and the mean PSA and prostate size were 10 ± 5.4 ng/mL, 134 ± 29.6 g, respectively. No significant difference was found between preoperative PSA values and prostate sizes in patients with and without prostate cancer (p>0.05). Incidental prostate cancer was in the Gleason 3+3=6 pattern in all patients and no increase in PSA was observed in any patient.
Conclusion:
The incidental prostate cancer rate found in our study was lower than the literature. In the pathology specimen, patients with incidental prostate cancer, especially those with low grade, can be followed without additional treatment.
Keywords:
Open prostatectomy, benign prostatic hyperplasia, prostate cancer, chronic prostatitis
References
1Pariser JJ, Packiam VT, Adamsky MA, Bales GT . Trends in Simple Prostatectomy for Benign Prostatic Hyperplasia. Curr Urol Rep 2016;17:57. doi:10.1007/s11934-016-0610-6.
2Capitanio U, Cheng L, Lopez-Beltran A, Scarpelli M, Freschi M, Montorsi F, Montironi R. The importance of interaction between urologists and pathologists in incidental prostate cancer management. Eur Urol 2011;60:75-77. doi:10.1016/j.eururo.2011.03.012.
3Oelke M, Bachmann A, Descazeaud A, Emberton M, Gravas S, Michel MC, N’Dow J, Nordling J, de la Rosette JJ, European Association of EAU guidelines on the treatment and follow-up of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction. Eur Urol 2013;64:118-140. doi:10.1016/j.eururo.2013.03.004.
4Rieken M, Gratzke C. Have we really abandoned open simple prostatectomy today? Eur Urol 2014; 66:292-293. doi:10.1016/j.eururo.2014.04.026.
5Morita M, Matsuura T. Successful treatment of incidental prostate cancer by radical transurethral resection of prostate cancer. Clin Genitourin Cancer 2013;11:94-99. doi:10.1016/j.clgc.2012.09.012.
6Capogrosso P, Capitanio U, Vertosick EA, Ventimiglia E, Chierigo F, Oreggia D, Moretti D, Briganti A, Vickers AJ, Montorsi F, Salonia A. Temporal Trend in Incidental Prostate Cancer Detection at Surgery for Benign Prostatic Hyperplasia. Urology. 2018;122:152-157. doi:10.1016/j.urology.2018.07.028.
7Abedi AR, Fallah-Karkan M, Allameh F, Ranjbar A, Shadmehr A. Incidental prostate cancer: a 10-year review of a tertiary center, Tehran, Iran. Res Rep Urol. 2018; 9;10:1-6. doi:10.2147/RRU.S146159.
8Elkoushy MA, Elshal AM, Elhilali MM. Incidental Prostate Cancer Diagnosis During Holmium Laser Enucleation: Assessment of Predictors, Survival, and Disease Progression. Urology 2015;86:552-557. doi:10.1016/j.urology.2015.06.002.
