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Minerva Urologica e Nefrologica 2020 Jan 29

DOI: 10.23736/S0393-2249.19.03564-1

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

Incidental prostate cancer after transurethral resection of the prostate: analysis of incidence and risk factors in 458 patients

Antonio B. PORCARO 1 , Alessandro TAFURI 1, 2, Davide INVERARDI 1, Nelia AMIGONI 1, Marco SEBBEN 1, Marco PIROZZI 1, Tania PROCESSALI 1, Riccardo RIZZETTO 1, Aliasger SHAKIR 2, Clara CERRATO 1, Leone TISO 1, Andrea PANUNZIO 1, Mario DE MICHELE 1, Matteo BRUNELLI 3, Salvatore SIRACUSANO 1, Walter ARTIBANI 1

1 Department of Urology, Azienda Ospedaliera Universitaria Integrata, University of Verona, Verona, Italy; 2 Department of Urology, USC Institute of Urology and Catherine and Joseph Aresty, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA; 3 Department of Pathology, Azienda Ospedaliera Universitaria Integrata, University of Verona, Verona, Italy


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BACKGROUND: To evaluate the incidence and risk factors of incidental prostate cancer (IPCA) in a contemporary cohort of lower urinary tract symptoms (LUTS) patients who underwent trans-urethral resection of the prostate (TURP).
METHODS: A series of 458 consecutive patients who underwent TURP were evaluated between January 2016 to June 2018. Evaluated factors included age (years), body mass index (BMI; kg/square meters), treatment with inhibitors of 5-alpha reductase, previous prostate biopsies, basal prostate specific antigen (PSA) levels (ng/mL), serum leukocyte count (n*10^9/L), weight of resected prostate tissue (grams), grade and stage of IPCA. The multivariate logistic regression model evaluated associations of significant clinical factors with the risk of IPCA.
RESULTS: Overall, IPCA was detected in 30 out of 454 patients (6,6%). A mean of 21,8 grams of tissue was resected. The mean number of positive chips was 5,6 (mean percentage 3,9%) with tumor grade group 1 in 22 cases (73,4%) and tumor stage cT1a in 23 patients (76,7%). On multivariate analysis, independent factors that were positively associated with the risk of IPCA were BMI (odds ratio, OR = 1,121; p = 0,017) and leukocyte count (OR = 1,144; p = 0,027).
CONCLUSIONS: In a contemporary cohort of patients undergoing TURP for the treatment of LUTS, the risk of IPCA was not negligible with a rate of being 6,6%. BMI and serum leukocyte count were found to be independent factors that were positively associated with the risk of IPCA.


KEY WORDS: Prostate cancer; Incidental prostate cancer; Transurethral resection of the prostate; Prostate tumor grade

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