Onkológia 4/2020

Incidental prostate adenocarcinoma detected by transurethral resection of the prostate

Introduction: Prostate cancer (CaP) is the second most common cancer in males. The likelihood of developing this disease increases significantly with age. Patients undergoing transurethral resection of the prostate (TUR-P) for lower urinary tract symptoms (LUTS) should be thoroughly examined prior to the procedure to minimize the risk of incidental detection of CaP. The incidence of incidental CaP in the range of 1.4-8% has been reported in the literature. The aim of this study was to objectively evaluate the incidence of incidental CaP in patients who underwent TUR-P for LUTS over a period of 7 years at our department. Patients and methods: We retrospectively analyse data from 872 patients aged 48-92 years (mean 68.3 years) who underwent in 2013-2019 TUR-P for LUTS after failure of conservative treatment. Patients underwent TUR-P directly with prostate specific antigen (PSA) and digital rectal examination (DRE) negativity. If DRE is positive and/or PSA is elevated, the patients underwent a prostate biopsy before TUR-P. Results: Histologically was CaP identified in 35 patients (4.01%). In 19 patients (54.3%), a prostate biopsy was performed before TUR-P because of positive DRE and/or elevated PSA. 25 (71.4%) patients with incidental CaP were in the pT1a stage and 10 patients (28.6%) were in the pT1b stage. Conclusion: Despite precise examination of patients, CaP can be diagnosed incidentally in TUR-P. Its occurrence in our file was comparable to previously published studies. Patients undergoing surgical treatment with LUTS should be informed of the possibility of detecting incidental CaP.

Keywords: prostate cancer, incidental occurrence, transurethral resection of the prostate