title: Survival after incidental prostate cancer diagnosis at transurethral resection of prostate: 10-year outcomes.
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.
  
  
  OBJECTIVE
  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.
authors: Department of Urology, The Adelaide and Meath Hospital incorporating the National Children's Hospital, Tallaght, Dublin, Ireland. drsarfrazrana@hotmail.com
authors: S
authors: S
authors: Ahmad
authors: F
authors: F
authors: O'Kelly
authors: R P
authors: RP
authors: Manecksha
authors: I M
authors: IM
authors: Cullen
authors: R J
authors: RJ
authors: Flynn
authors: T E D
authors: TE
authors: McDermott
authors: R
authors: R
authors: Grainger
authors: J A
authors: JA
authors: Thornhill
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D053448:Prostatism / Q000601:surgery; D011878:Radiotherapy; D016019:Survival Analysis; D057832:Watchful Waiting
chemical_list: D018931:Antineoplastic Agents, Hormonal