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Quantitation of Potentially Undiagnosed Incidental Carcinoma of the Prostate in Patients Treated Non‐surgically for Benign Prostatic Hyperplasia
Author(s) -
ANDERSON G. A.,
LAWSON R. K.,
GOTTLIEB M. S.
Publication year - 1993
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1993.tb16179.x
Subject(s) - medicine , prostatectomy , prostate cancer , urology , stage (stratigraphy) , prostate , prostatism , population , cancer , hyperplasia , carcinoma , surgery , prostate disease , paleontology , environmental health , biology
Summary Prostatectomy is the standard treatment for benign prostatic hyperplasia (BPH) and non‐surgical treatment of prostatism would reduce the detection of Stage A prostate cancer. We wished to identify the number of potentially undiagnosed cancers resulting if non‐surgical therapy were used to treat a presenting complaint of BPH. We also sought to identify the age group which would most clearly benefit from treatment of Stage A prostate cancer. Our series of transurethral prostatectomy specimens showed 92/996 patients (9.2%) positive for incidental carcinoma; 26/92 patients (28%) received further treatment and 25 of the 26 patients had Stage A2 disease. After evaluating life‐tables and survival data on untreated A2 disease, the population aged 72 years had a relative benefit of treatment ratio > 1.0, i.e. had a greater likelihood of dying from prostate cancer than from natural causes; 17/616 (2.8%) of the population aged < 72 years had their A2 disease treated and would have potentially been denied early cancer treatment if non‐surgical management of BPH had been employed. The above figures assume 100% non‐surgical treatment of BPH and no screening for prostate cancer pre‐treatment. Stage A2 patients in this study demonstrated no significant difference in cause‐specific survival rates between treated and untreated study groups (both 0%) or between treated study patients and untreated historical patients. Treated A2 patients demonstrated a significantly lower 5‐year progression rate (0 vs 32%) relative to untreated patients reported in the literature, and a trend toward a significantly lower progression rate (0 vs 25%) relative to untreated study patients.