Preoperative parameters to predict incidental (T1a and T1b) prostate cancer

Abstract

Cite as: Can Urol Assoc J 2014;8(11-12):e815-20. http://dx.doi.org/10.5489/cuaj.1890 Published online November 24, 2014. AbstractIntroduction: Prostate cancer has been found incidentally in transurethral resection of the prostate (TURP) specimens without prior diagnosis in 5% to 13% of the patients. We evaluated whether incidental prostate cancer (stages T1a and T1b) could be predicted preoperatively. Methods: TURP was performed in 307 patients between 2006 and 2011. Patient age, prostate-specific antigen (PSA) level, total prostate volume, transitional zone volume, PSA density, history of needle biopsy, and pathological diagnosis on TURP specimen were assessed. We analyzed the association between these parameters and prostate cancer detection. Results: Incidental prostate cancer was found in 31 patients

Holmium Laser Enucleation of the Prostate Provides Similar Incidental Prostate Cancer Detection Rates as Open Prostatectomy: A Matched Pair Analysis

“…In literature, incidental prostate cancer (iPCa) rates vary depending on preoperative factors, such as patient age, preoperative prostate-specific antigen (PSA), prostate volume, and preoperative biopsy performance [8][9][10][11][12]. Recently, we additionally supported the idea that the surgical procedure itself has an influence on iPCa detection, as we demonstrated that HoLEP provides a superior iPCa detection rate compared to bipolar transurethral resection of the prostate (TURP) in a matched pair analysis [8].…”

“…The quality of our matching was verified by almost identical preoperative baseline patient characteristics regarding age, preoperative PSA, preoperative prostate volume, PSA density, and preoperative biopsy rates. This is particularly critical as those parameters have been shown to be predictive for iPCa after desobstruction [8][9][10][11][12].…”

“…As age, preoperative prostate volume (determined by transrectal ultrasound) and preoperative total PSA value have been identified as independent predictors for iPCa detection [9][10][11][12], we used these parameters as primary matching criteria. Patients with known prostate cancer before desobstructive surgery were excluded.…”

Robotic Assisted Laparoscopic Prostatectomy Performed after Previous Suprapubic Prostatectomy

“…Historically, prostate cancer has been identified in TURP specimens without prior diagnosis in 5 to 13% of patients [6]. A recent study by Sakamoto et al found incidental prostate cancer in 10% of patients who underwent TURP, with 4% of the total cohort having stage T1b and/or Gleason ≥7 [6].…”

“…A recent study by Sakamoto et al found incidental prostate cancer in 10% of patients who underwent TURP, with 4% of the total cohort having stage T1b and/or Gleason ≥7 [6]. In a larger cohort studied by Otto et al, 11/771 patients had incidental prostate cancer, 10 of whom had Gleason grade 3+3 disease and only one with Gleason grade 3+4 disease.…”