T1a/T1b transitional zone prostate cancer detection rates in patients who had TURP for clinically diagnosed benign prostatic enlargement in Southern Nigeria
DOI:
https://doi.org/10.47672/ejhs.995Keywords:
Incidental cancer, prostate cancer, transitional zone, T1a, T1b, TURPAbstract
Background: Transurethral resection of the prostate (TURP) removes the obstructing adenoma that grows from the transitional zone of the prostate. Resected chips are routinely sent for histologic examination. Incidental findings of prostate cancer in the TURP specimen for the clinically diagnosed benign disease may occur. The American Joint Committee on Cancer (AJCC) TNM staging of prostate cancer allocates T1a if <5% of the resected chips are malignant and T1b if >5% are malignant.
Aim: To determine the frequency of incidental prostate cancer rate in TURP specimens of patients who had the procedure for clinically diagnosed benign prostatic enlargement.
Methodology: This was a retrospective study carried out over a period of 8years from January 2013 to December 2020 on patients who had TURP for clinically diagnosed BPE or biopsy diagnosed BPH. All the patients had TURP for benign enlargements of the prostate. The resected prostate chips were sent for histopathological analysis. Patients with incomplete data and patients who had transrectal peripheral zone prostate biopsy confirmed cancers before TURP were excluded from this study. The data was collated using Microsoft Excel version 2020 and was analyzed using SPSS version 20.
Results: There were 220 male patients with a mean age was 65.89 ±9.95years, and median age was 65years. The 60-69years group had the highest incidence of PCa. The T1a/T1b adenocarcinoma detection rate was 13.6% (30). 54.6% (120) had BPH only, and 31.8% (70) had BPH with prostatitis. All incidentally diagnosed T1a/T1b cancers were adenocarcinomas. The majority of the T1a/T1b adenocarcinomas, 43.3% (13), were poorly differentiated, while 36.7% (11) and 20% (6) had well and moderate differentiation, respectively.
Conclusion: The Incidental T1a/T1b transitional zone adenocarcinoma detection rate in TURP specimens in the study was 13.6%. The high Gleason's grade adenocarcinoma was the most frequent. Even when perceived as clinically benign, communication of the risk of cancer detection to the patient is pertinent and should be a routine part of the informed consenting process before TURP.
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