Introduction and Objectives
The aim of this study was to compare the incidence of incidental prostatic carcinoma in two hospitals in Croatia according to the procedure of choice, together with incidence and its clinical caracteristics.
Material and Methods
The hospital medical records of all patients who have undergone prostatectomy for BPH in two hospitals, namely University Hospital Osijek and General Hospital Varǎzdin, in the period between January 2002 and December 2006 were reviewed. In 202 cases retropubic prostatectomy was performed and in 842 transurethral resection was done.
Results
The histopathology reports obtained from 1044 patients who presented with BPH were available. Incidental carcinoma was found in 71 specimens (representing 6.80% of all patients). The mean age was 70.6 years (44 to 90). Gleason score ranged between 3 and 6 with a mean value of 4.1. In 43 cases (60.56%) postoperative PSA values were stable and ranged between 0.0 to 0.5 ng/ml. In 28 cases after the postoperative rise in the PSA levels patients underwent bilateral orchydectomy and in 13 of those patients after the further rise in the PSA levels we deceided to include flutamid in the therapy. Five of those patients (7.04%) died because of concomitant diseases. Two patients (2.81%) developed osseous metastases of the prostatic carcinoma.
Conclusions
Considering the operative technique there were 9 cases (4.45%) of incidental prostatic carcinoma following open prostatectomy and 62 cases (7.36%) following TURP (p = 0.05). The reason for such discrepancies in the results could be that during the open procedures only the adenomatous tissue of transitional zone is removed, while during transurethral procedure there is presence of the tissue that is resected from the peripheral zone which is more prone for development of prostatic carcinoma.
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Copyright
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.
