title: Incidental prostate cancer in transurethral resection of prostate specimens in men aged up to 65 years.
abstract: BACKGROUND
  The identification of prostate cancer (PC) is important in men aged ≤ 65 years. We examined complete transurethral resection of prostate (TURP) specimens to quantify the incidence and nature of PC in men aged ≤ 65 years.
  
  
  METHODS
  A prospective multi-institutional database included TURP specimens. The cohort was stratified into two groups according to age. For men aged ≤ 65 years, the entire specimen was submitted for histological analysis, while the TURP specimens from men aged > 65 years were sampled following standard guidelines.
  
  
  RESULTS
  A total of 923 men were included, with 224 in the younger group. PC was identified in 13.4% in men aged ≤ 65 years, compared with 28.7% the older group. The younger group had a lower proportion of Gleason score ≥ 7 (30% compared with 40%) and higher rates of pT1a (57% compared with 43%). In men aged ≤ 65 years with cancer, tumor was identified in one block in 15 of 30 cases (50%). Following diagnosis, 4/30 underwent radical prostatectomy, 5/30 underwent curative radiotherapy, 10/30 androgen deprivation, and 1/30 received palliative radiotherapy.
  
  
  CONCLUSIONS
  Incidental PC in men aged ≤ 65 years is not uncommon. Our results suggest that TURP specimens in men aged ≤ 65 years should be completely assessed. Underidentification of cancer may occur as a result of increasing use of laser prostatectomy and the consequent loss of tissue for pathological examination.
authors.affiliation: School of Medicine, University of Queensland, St Lucia, QLD, Australia; Department of Surgery, University of Melbourne, VIC, Australia.
authors.forename: Marlon
authors.initials: M
authors.lastname: Perera
authors.affiliation: Department of Surgery, University of Melbourne, VIC, Australia; Ludwig Institute for Cancer Research, Austin Hospital, Heidelberg, VIC, Australia; Department of Urology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
authors.forename: Nathan
authors.initials: N
authors.lastname: Lawrentschuk
authors.affiliation: Department of Surgery, University of Melbourne, VIC, Australia.
authors.forename: Nayomi
authors.initials: N
authors.lastname: Perera
authors.affiliation: Department of Surgery, University of Melbourne, VIC, Australia; Ludwig Institute for Cancer Research, Austin Hospital, Heidelberg, VIC, Australia.
authors.forename: Damien
authors.initials: D
authors.lastname: Bolton
authors.affiliation: Tissue Path, Glen Waverly, VIC, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Clouston
keywords: Incidental prostate cancer; Prostatic neoplasms; Radical prostatectomy; Surgery; Transurethral resection of prostate