Incidental prostate cancer in transurethral resection of prostate specimens in men aged up to 65 years

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• 作者：Marlon Perera¹ ; ² ; ^{marlonlperera@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Nathan Lawrentschuk² ; ³ ; ⁴ ; Nayomi Perera² ; Damien Bolton² ; ³ ; David Clouston⁵
• 关键词：Incidental prostate cancer ; Prostatic neoplasms ; Radical prostatectomy ; Surgery ; Transurethral resection of prostate
• 刊名：Prostate International
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：4
• 期：1
• 页码：11-14
• 全文大小：288 K

文摘

The identification of prostate cancer (PC) is important in men aged ≤ 65 years. We examined complete transurethral resection of prostate (TURP) specimens to quantify the incidence and nature of PC in men aged ≤ 65 years.

Methods

A prospective multi-institutional database included TURP specimens. The cohort was stratified into two groups according to age. For men aged ≤ 65 years, the entire specimen was submitted for histological analysis, while the TURP specimens from men aged > 65 years were sampled following standard guidelines.

Results

A total of 923 men were included, with 224 in the younger group. PC was identified in 13.4% in men aged ≤ 65 years, compared with 28.7% the older group. The younger group had a lower proportion of Gleason score ≥ 7 (30% compared with 40%) and higher rates of pT1a (57% compared with 43%). In men aged ≤ 65 years with cancer, tumor was identified in one block in 15 of 30 cases (50%). Following diagnosis, 4/30 underwent radical prostatectomy, 5/30 underwent curative radiotherapy, 10/30 androgen deprivation, and 1/30 received palliative radiotherapy.

Conclusion

Incidental PC in men aged ≤ 65 years is not uncommon. Our results suggest that TURP specimens in men aged ≤ 65 years should be completely assessed. Underidentification of cancer may occur as a result of increasing use of laser prostatectomy and the consequent loss of tissue for pathological examination.