[Incidental prostatic cancer].
OBJECTIVE
To evaluate the incidence of incidental prostate cancer and PSA ability to predict its presence.


METHODS
Retrospective study of 862 patients undergoing prostate surgery between 1994 and 1997, both inclusive. Digital rectal examination provided no suspicion of neoformation. Mean age was 68 +/- 7.5 years. Mean PSA, 8.3 +/- 10 ng/ml (Hybritech). 15% patients had previously undergone at least one ultrasound-guided biopsy in the peripheral area. 55% patients underwent retropubic surgery and the remaining 45% prostate transurethral resection. Ultrasound prostate volume for both patient groups was 107 +/- 63 cc and 45 +/- 25 cc, respectively.


RESULTS
Incidental cancer was found in 6% patients; 65% were T1a and 35% T1b. Mean PSA concentration in cancer patients was almost significantly (p = 0.05) higher than in patients with BPH. Patients with PSA > 10 ng/ml presented a significantly higher incidence of cancer (p = 0.02). Patients with previous prostate biopsy showed a cancer incidence rate of 12% versus 5% patients with no previous biopsy (p = 0.001).


CONCLUSIONS
Incidence of incidental prostate cancer was 6%. PSA was not a good predictor of incidental cancer. Patients with PSA > 10 ng/ml, showed higher incidence of cancer. Younger patients with PSA > 10 ng/ml, and at least one negative biopsy of the peripheral area should undergo biopsy of the transitional area prior to surgery.
Herranz Amo
F
F
Servicio de Urología, H.G.U. Gregorio Marañón, Madrid.
Díez Cordero
J M
JM
Verdú Tartajo
F
F
Leal Hernández
F
F
Bielsa Carrillo
A
A
García Burgos
J
J
Subirá Ríos
D
D
D000368:Aged; D006801:Humans; D015994:Incidence; D008297:Male; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D012189:Retrospective Studies
D017430:Prostate-Specific Antigen