Temporal trend in incidental prostate cancer detection at surgery for benign prostatic hyperplasia Journal Article

Authors: Capogrosso, P.; Capitanio, U.; Vertosick, E. A.; Ventimiglia, E.; Chierigo, F.; Oreggia, D.; Moretti, D.; Briganti, A.; Vickers, A. J.; Montorsi, F.; Salonia, A.
Article Title: Temporal trend in incidental prostate cancer detection at surgery for benign prostatic hyperplasia
Abstract: Objective: To assess changes in the rate of incidental prostate cancer (PCa) after benign prostatic hyperplasia (BPH) surgery over the last decade. Materials and Methods: We identified 1177 patients surgically treated for BPH (open prostatectomy, transurethral resection or holmium laser enucleation [HoLEP] of the prostate) in 2007-2016 at a single European academic center. Local polynomial regression was used to explore changes in the rate of incidental PCa detected after BPH surgery and of preoperative biopsy performed over time. Logistic regression analyses tested the association of incidental PCa diagnosis with year of surgery and preoperative biopsy. Results: Incidental PCa was found in 6.4% (74) of cases, 67 (91%) with Grade group 1 disease. We observed an increased incidence of PCa diagnosis after BPH surgery over time (odds ratio [OR]: 1.12; 95%confidence interval [CI]: 1.02-1.24, P =.02) along with a concomitant decrease in the rate of preoperative prostate biopsies (OR: 0.83; 95%CI: 0.79-0.88, P <.0001). Patients undergoing a preoperative biopsy showed a lower risk of being diagnosed with PCa after surgery (OR: 0.29; 95% CI: 0.12, 0.72 P =.007). Patients treated with HoLEP had a higher chance of incidental PCa detection (OR: 2.28; 95%CI: 1.30–4.00; P =.004), although this may be related to the significantly higher number of HoLEP performed over the last years. Conclusion: The increased rate of low-risk PCa detected after BPH surgery in the last decade reflects the clinical practice changes in PCa screening and diagnosis leading to a reduced number of unnecessary biopsies and indolent cancer diagnosis. © 2018
Journal Title: Urology
Volume: 122
ISSN: 0090-4295
Publisher: Elsevier Science, Inc.  
Date Published: 2018-12-01
Start Page: 152
End Page: 157
Language: English
DOI: 10.1016/j.urology.2018.07.028
PROVIDER: scopus
PUBMED: 30138683
Notes: Urology -- Export Date: 2 January 2019 -- Article -- CODEN: URGYA -- Source: Scopus
Altmetric Score
MSK Authors
  1. Andrew J Vickers
    565 Vickers