Abstract
Background
The most appropriate management of incidental prostate cancers diagnosed at transurethral resection of prostate has been debated. It is important to determine the long-term outcomes to establish an appropriate management in patients with incidental prostate cancer.
Aims
We aim to determine 10-year survival and to identify the factors of worse prognosis of incidental prostate cancers diagnosed at transurethral resection of prostate.
Methods
A retrospective analysis of patients with pT1a–pT1b prostate cancers diagnosed between 1998 and 2003. Medical notes, PSA and pathology results were reviewed. Overall and cancer specific survival was calculated at mean 10-year follow-up.
Results
Sixty patients with incidental prostate cancer were identified (pT1a = 18, pT1b = 42). Fifty-one percents of the patients were managed on a watchful waiting strategy with overall 84% survival and 9.7% cancer specific mortality. Twenty patients (all with pT1b) received hormone therapy. Overall survival in this cohort was 50% with 20% cancer specific mortality. Nine patients received curative therapy (Radical prostatectomy = 4, Radiotherapy = 5). In this group, overall survival was 88% with no cancer specific mortality.
Conclusions
Stage pT1a disease and preoperative low PSA were associated with favourable survival. However, for pT1b and/or high Gleason score (≥7), mortality was comparatively higher. Hence, patients with high Gleason score and/or pT1b disease should be considered for curative therapy. Additionally, active surveillance may have a role in selected men with incidental prostate cancer.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Epstein JI, Paull G, Eggleston JC, Walsh PC et al (1986) Prognosis of untreated stage A1 prostatic carcinoma: a study of 94 cases with extended follow-up. J Urol 136(4):837–839
Tombal B, De Visccher L, Cosyns JP et al (1999) Assessing the risk of unsuspected prostate cancer in patients with benign prostatic hypertrophy: a 13-year retrospective study of the incidence and natural history of T1a–T1b prostate cancers. BJU Int 84(9):1015–1020
Descazeaud A, Peyromaure M, Salin A et al (2008) Predictive factors for progression in patients with clinical stage T1a prostate cancer in the PSA era. Eur Urol 53(2):355–361
Capitanio U, Scattoni V, Freschi M et al (2008) Radical prostatectomy for incidental (stage T1a–T1b) prostate cancer: analysis of predictors for residual disease and biochemical recurrence. Eur Urol 54(1):118–125
Helfand BT, Mongiu AK, Kan D et al (2009) Outcomes of radical prostatectomy for patients with clinical stage T1a and T1b disease. BJU Int 104(3):304–309
Chodak GW (1994) The role of conservative management in localized prostate cancer. Cancer 74(Suppl (7)):2178–2181
Aus G, Hugosson J, Norlen J et al (1995) Long-term survival and mortality in prostate cancer treated with noncurative intent. J Urol 154(2 Pt 1):460–465
Talcott JA, Rossi C, Shipley WU et al (2010) Patient-reported long-term outcomes after conventional and high-dose combined proton and photon radiation for early prostate cancer. JAMA 303(11):1046–1053
Adolfsson J (2008) Watchful waiting and active surveillance: the current position. BJU Int 102(1):10–14
Pierorazio PM, Humphreys E, Walsh PC, Partin AW, Han M (2010) Radical prostatectomy in older men: survival outcomes in septuagenarians and octogenarians. BJU Int 106(6):791–795
Rajab R, Fisher G, Kattan MW et al (2011) An improved prognostic model for stage T1a and T1b prostate cancer by assessments of cancer extent. Mod Pathol 24(1):58–63
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ahmad, S., O’Kelly, F., Manecksha, R.P. et al. Survival after incidental prostate cancer diagnosis at transurethral resection of prostate: 10-year outcomes. Ir J Med Sci 181, 27–31 (2012). https://doi.org/10.1007/s11845-011-0753-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11845-011-0753-x