Korean J Urol.  2012 Jun;53(6):391-395.

Preoperative Clinical Factors for Diagnosis of Incidental Prostate Cancer in the Era of Tissue-Ablative Surgery for Benign Prostatic Hyperplasia: A Korean Multi-Center Review

• Yoo C
• Oh CY
• Kim SJ
• Kim SI
• Kim YS
• Park JY
• Seong DH
• Song YS
• Yang WJ
• Chung HC
• Cho IR
• Cho SY
• Cheon SH
• Hong S
• Cho JS

Abstract

PURPOSE
To identify potential predictive factors of incidental prostate cancer (IPca) in patients considering tissue-ablation treatment for benign prostatic hyperplasia (BPH).
MATERIALS AND METHODS
From the 11 centers, 1,613 men who underwent transurethral resection of the prostate (TURP) or open prostatectomy were included. Before surgery, prostate biopsy was performed in all patients with prostate-specific antigen (PSA) > or =4.0 ng/ml or with abnormal digital rectal examination (DRE) findings. The patients with prostate cancer preoperatively or with PSA >20 ng/ml were excluded. As predictive factors of IPca, age, body mass index, PSA, DRE, and transrectal ultrasonography (TRUS) findings, including total prostate volume (TPV), transition zone volume (TZV), and the presence of hypoechoic lesions, were reviewed. PSA density (PSAD) and PSAD in the transition zone (PSAD-TZV) were calculated.
RESULTS
IPca was diagnosed in 78 patients (4.8%). DRE findings, PSA, and TZV were independent predictive factors in the multivariate analysis. In the receiver operating characteristic curve analysis of PSA, PSAD, and PSAD-TZV, the area under the curve (AUC) was the largest for PSAD-TZV (AUC, 0.685).
CONCLUSIONS
IPca was detected in 4.8% of the population studied. In addition to DRE findings, the combination of TZV and PSA can be useful predictive factors of IPca in patients considering tissue-ablation treatment as well as TURP.

Keyword

Prostate neoplasms; Prostatic hyperplasia; Transurethral resection of prostate

MeSH Terms

Biopsy
Body Mass Index
Cyanoacrylates
Digital Rectal Examination
Humans
Male
Multivariate Analysis
Prostate
Prostate-Specific Antigen
Prostatectomy
Prostatic Hyperplasia
Prostatic Neoplasms
ROC Curve
Transurethral Resection of Prostate
Cyanoacrylates
Prostate-Specific Antigen

Figure

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  FIG. 1 Receiver operating characteristic curve analysis of prostate-specific antigen (PSA), PSA density (PSAD), and PSAD-in transition zone volume (PSAD-TZV) on risk of incidental prostate cancer in the patients who underwent surgical treatment for benign prostatic hyperplasia. AUC, area under the curve; CI, confidence interval.

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