Open AccessIs there a PSA cut-off value indicating incidental prostate cancer in patients undergoing surgery for benign prostatic hyperplasia?
Author(s) -
Şenol Tonyalı,
Cavit Ceylan,
Erdoğan Ağlamış,
Selami Doğan,
Sedat Taştemur,
Mustafa Karaaslan
Publication year - 2021
Publication title -
archivio italiano di urologia andrologia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.429
H-Index - 23
eISSN - 2282-4197
pISSN - 1124-3562
DOI - 10.4081/aiua.2021.1.31
Subject(s) - medicine , urology , rectal examination , prostate cancer , prostatectomy , hyperplasia , prostate , malignancy , prostate specific antigen , open prostatectomy , biopsy , transurethral resection of the prostate , prostate biopsy , cancer
Aim: To investigate incidental prostate cancer (IPCa) rate and to determine prostate specific antigen (PSA) cut-off value indicating PCa in patients who underwent surgery by being diagnosed with benign prostatic hyperplasia (BPH) clinically or by standard prostate biopsy. Methods: Data of 317 patients, who underwent transurethral resection of the prostate (TURP) or open prostatectomy (OP) with pre-diagnosis of BPH, were evaluated retrospectively. The examined parameters included patients’ demographics, preoperative serum PSA values, digital rectal examination (DRE) findings, surgical method, histopathological findings and Gleason Scores.Results: A total of 317 patients were included the study. The median age of patients was 69 years (min: 51-max: 79) and the median PSA value was 3.24 ng/dl (min: 0.17-max: 34.9). In 21 patients (6.6%); DRE findings were in favor of malignancy, but prostate biopsy resulted as BPH. While 281 (88.6%) of the patients underwent TURP, 36 (11.4%) underwent open prostatectomy. PCa was detected in 21 (6.6%) patients. PSA was statistically higher in patients who underwent OP compared to patient who underwent TUR-P, 5.9 (min: 1.2 - max: 27.6, IR: 8.7) vs. 2.8 (min: 0.1-max: 34.9, IR: 4.2) ng/dl, p < .001. The rate of IPCa among four PSA group was similar (p = 0.46). There was no difference between the rate of IPCa in patients younger and older than 70 years, (p = 0.11). Please change whole sentence as 'The median PSA level was slightly higher in patients diagnosed with BPH compared to patients diagnosed with IPCa, 3.2 (min: 0.1-max: 34.9) vs. 2.7 (min: 0.3-max: 26.5) ng/dL, p = 0.9. Conclusions: IPCa still remains an important clinical problem. We were not able to find any correlation of PSA and age with incidental PCa.