Survival after incidental prostate cancer diagnosis at transurethral resection of prostate: 10-year outcomes

Ahmad, Sarfraz; O’Kelly, Fardod; Manecksha, Rustom P.; Cullen, Ivor M.; Flynn, R; McDermott, Ted; Grainger, Ronald G.; Thornhill, John

doi:10.1007/s11845-011-0753-x

Cited by 11 publications

(9 citation statements)

References 11 publications

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“…Our study had similar observation that patients who were older than 65 years were as well more likely to have T1b tumors as compared to those younger than 65years with an increased tendency to have poorly differentiated prostatic carcinoma than their younger counter parts. Ahmad and colleagues from Ireland in 2012 in addition found that the survival rate was significantly reduced among those patients with these advanced lesions ( 20 ). In this study, it was shown that with an overall survival of 88% at 10 years of watchful waiting, the survival rate was only 50% among those patients with T1b incidental prostatic carcinoma with increased cancer specific mortality of 20%.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and associated factors of incidentally diagnosed prostatic carcinoma among patients who had transurethral prostatectomy in Tanzania: a retrospective study

Gunda¹,

Kido²,

Kilonzo³

et al. 2018

Ethiop J Health Sci

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Background Prostatic carcinoma carries a high morbidity and mortality if it is not diagnosed early. In resource limited countries, patients are at increased risk of being diagnosed late as they are operated for presumed benign prostatic hyperplasia. The information on the magnitude and risk factors of this problem in our setting could assist in the overall optimization of care of patients at risk. Methods A retrospective study of patients who underwent prostatectomy for presumed benign prostatic enlargement was done at Bugando University Hspital in Tanzania. Patients' age, creatinine levels, urological Ultrasound, prostate specific antigen and Biopsy results were analyzed using STATA 11. The prevalence of incidental prostatic cancer was calculated and logistic regression was done for factors associated with incidental prostatic cancer. Results In total, 152 patients were included in this study. The median age was 69 (SD 9.4) years, 16 (10.53%,) and 49 (32.24%) participants had Hydronephrosis and elevated creatinine levels respectively. Eighty six (58.56%) patients had PSA >10 ng/mL and in total; 33 (21.71%) had incidental prostatic carcinoma. The incidental prostatic carcinoma was independently associated with age of 70– 80years (AOR=2.8, p = 0.013) and PSA levels >10ng/mL (AOR=3.2, p=0.014). Conclusions The prevalence of incidental prostatic carcinoma is high among patients undergoing transurethral prostatectomy for presumed benign prostatic hyperplasia in Tanzania with increased risk at age of 70–80 years and among those with PSA >10ng/mL. A national awareness campaign coupled with focused screening of patients above 60 years could increase the detection rate of prostatic carcinoma and reduce the magnitude of incidental diagnosis of this disease.

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Section: Discussionmentioning

confidence: 99%

Prevalence and associated factors of incidentally diagnosed prostatic carcinoma among patients who had transurethral prostatectomy in Tanzania: a retrospective study

Gunda¹,

Kido²,

Kilonzo³

et al. 2018

Ethiop J Health Sci

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“…Of these patients, 9 received HT and 5 RP. In two further retrospective studies, WW was the treatment of choice, serial PSA values were not communicated [18,19]. Only Descazeaud et al reported on 144 patients with stage T1a tumors; they were initially monitored and in case of increased PSA, subjected to a transrectal core needle biopsy of the prostate and/or a diagnostic work-up based on imaging studies.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Incidental Prostate Cancer by Active Surveillance: Results of the HAROW Study

et al. 2015

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Objective: To report on a cohort of patients with incidental prostate cancer (IPC) that was treated by an active surveillance (AS) protocol in the HAROW study. Materials and Methods: The HAROW study is an observational study on the management of localized prostate cancer in Germany. Treating urologists were reporting clinical parameters, information on therapy and clinical course of disease at 6-month intervals. Results: In total, 3,169 patients were enrolled. In 224 patients were found an IPC and 104 (46%) of them were put on an AS protocol. The mean follow-up was 26.5 months. Tumor progression was noted in 16 patients. In 11 patients, AS was replaced by a definite intervention. In univariate and multivariate analyses, only PSA density correlated with progression. Conclusion: This is the first prospective description of an IPC patient cohort on AS as part of an outcomes research study. AS was selected as a therapeutic strategy in nearly half of the patients (46%). Only a minor proportion (16%) displayed progression. Of the clinical parameters, only PSA density correlated with progression.

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“…Nonetheless, no matter what type of uptake is seen in patients who have nonaggressive underlying malignancies, this finding should be further evaluated, as incidentally found prostate cancers can also cause mortality in this once thought nonlethal disease [19, 20] and the treatment may be based on the grade, stage, and the age of the patient [18, 21]. Studies have shown survival benefit in patients who have incidental prostate cancers resected during cystoprostatectomy for bladder cancer [22] and such studies need to be performed in the setting of other malignancies.…”

Section: Discussionmentioning

confidence: 99%

What Is the Clinical Significance of FDG Unexpected Uptake in the Prostate in Patients Undergoing PET/CT for Other Malignancies?

Bhosale

Balachandran

Vikram

et al. 2013

International Journal of Molecular Imaging

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Purpose. To determine the clinical significance of unexpected, abnormal FDG uptake in the prostate in patients undergoing FDG-PET/CT for staging of other primary malignancies without a prior history of prostate carcinoma. Methods. Retrospective search of FDG-PET/CT studies to identify patients with unexpected, abnormal FDG uptake in the prostate gland, who underwent subsequent biopsy, was performed. 26 patients were identified. Images were reviewed to determine the pattern of uptake within the prostate (focal or diffuse) and maximum standardized uptake value (SUVmax). PSA and Gleason scores were recorded. Results. 15/26 (58%) patients were found to have prostate carcinoma. Gleason scores ranged from 6 to 9.9. There was no statistical difference in the pattern of uptake (focal versus diffuse) or the SUVmax. Serum PSA levels with cancer (range, 2–26.8 ng; mean, 10.2 ng) and those without cancer (range, 2–10.5 ng; mean, 2.2 ng) were statistically significant (P < 0.007, Wilcoxon rank sum test). Conclusions. Patients with abnormal uptake in the prostate have a 58% likelihood of occult prostate cancer. In the setting of elevated serum PSA levels, abnormal prostate uptake should therefore be viewed with suspicion and a urology consult should be obtained; however, it is irrelevant in patients with underlying aggressive malignancies.

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Survival after incidental prostate cancer diagnosis at transurethral resection of prostate: 10-year outcomes

Cited by 11 publications

References 11 publications

Prevalence and associated factors of incidentally diagnosed prostatic carcinoma among patients who had transurethral prostatectomy in Tanzania: a retrospective study

Prevalence and associated factors of incidentally diagnosed prostatic carcinoma among patients who had transurethral prostatectomy in Tanzania: a retrospective study

Treatment of Incidental Prostate Cancer by Active Surveillance: Results of the HAROW Study

What Is the Clinical Significance of FDG Unexpected Uptake in the Prostate in Patients Undergoing PET/CT for Other Malignancies?

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