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Does mechanical morcellation of large glands compromise incidental prostate cancer detection on specimen analysis? A pathological comparison with open simple prostatectomy

World Journal of Urology volume 37, pages 1315–1320 (2019)Cite this article

Abstract

Objective

This study sought to compare the incidental prostate cancer (iPCa) detection rate between pathological specimens from green laser enucleation of the prostate (GreenLEP) and open simple prostatectomy (OSP).

Materials and methods

In two institutions, the charts of all consecutive patients who underwent OSP between January 2005 and December 2010 were retrospectively reviewed, and the data of all consecutive patients who underwent GreenLEP with tissue morcellation between July 2013 and January 2018 were also collected. Preoperative demographics and pathological findings were recorded. iPCa detection rate was retrospectively compared between the GreenLEP and OSP groups in a propensity score model, including all predetermined variables: Age, preoperative PSA level and prostate volume.

Results

Of 738 patients, 402 were included in the propensity-score matching analysis, and they were equally distributed among groups. The overall iPCa detection rates were similar in both groups (9.9% vs. 8.5%; p = 0.73), and there were no statistically significant differences in terms of tumour stage, Gleason score or the rate of clinically significant iPCa, although the number of cassettes analysed was significantly higher in the morcellation group than in the OSP group. No predictive factors for iPCa were identified.

Conclusions

The results of the present study suggest that the mechanical morcellation of large glands had no influence on iPCa detection. Compared with a specimen from standard OSP, a large morcellated tissue sample allows adequate pathological evaluation and does not alter a pathologist’s ability to detect iPCa.

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Author information

Affiliations

  1. Department of Urology, Clinique Pasteur, 31300, Toulouse, France

    Vincent Misraï, Marie Pasquie, Benoit Bordier & Julien Guillotreau

  2. Lariboisière University Hospital, ECSTRA Team, CRESS, Epidemiology and Statistics Centre, and University Denis Diderot, Paris, France

    Sébastien Kerever

  3. Department of Pathology, S.O. Path, Toulouse, France

    Julien Palasse

  4. Department of Pathology, Les Feuillants, Toulouse, France

    Virginie Guillotreau

  5. Department of Urology, Hospital Quirón Salud, Barcelona, Spain

    Enrique Rijo

  6. Department of Urology, Rennes Hospital, Rennes, France

    Sébastien Vincendeau, Romain Huet, Romain Mathieu & Benoit Peyronnet

  7. Department of Pathology, Rennes Hospital, Rennes, France

    Nathalie Rioux-Leclercq

  8. Department of Pathology, Tenon Hospital, AP-HP, University Pierre and Marie Curie, Paris, France

    Eva-Maria Compérat

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  1. Vincent Misraï
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  2. Sébastien Kerever
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  3. Marie Pasquie
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  4. Benoit Bordier
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  5. Julien Guillotreau
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  6. Julien Palasse
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  7. Virginie Guillotreau
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  8. Enrique Rijo
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  9. Sébastien Vincendeau
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  10. Romain Huet
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  11. Romain Mathieu
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  12. Benoit Peyronnet
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  13. Nathalie Rioux-Leclercq
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  14. Eva-Maria Compérat
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Corresponding author

Correspondence to Vincent Misraï.

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Conflict of interest

Vincent Misraï, Sébastien Vincendeau and Benoit Peyronnet are consultants for Boston Scientific. Sébastien Kerever, Marie Pasquie, Benoit Bordier, Julien Guillotreau, Julien Palasse, Virginie Guillotreau, Romain Huet, Romain Mathieu, Nathalie Rioux-Leclercq and Eva-Maria Compérat have no conflicts of interest to declare.

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Misraï, V., Kerever, S., Pasquie, M. et al. Does mechanical morcellation of large glands compromise incidental prostate cancer detection on specimen analysis? A pathological comparison with open simple prostatectomy. World J Urol 37, 1315–1320 (2019). https://doi.org/10.1007/s00345-018-2532-z

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  • DOI: https://doi.org/10.1007/s00345-018-2532-z

Keywords

  • Benign prostatic obstruction
  • Enucleation
  • Histology
  • Prostate cancer
  • Prostate-specific antigen