C88: Natural history of incidental prostate cancer after transurethral resection of the prostate

C88: Natural history of incidental prostate cancer after transurethral resection of the prostate Hradec T., Capoun O., Hanus T. General Teaching Hospital of The First Faculty of Medicine, Charles University, Dept. of Urology, Prague, Czech Republic INTRODUCTION & OBJECTIVES: To assess the management of patients with incidental prostate cancer found after transurethral resection of the prostate (TURP) MATERIAL & METHODS: In the period 01/2007 – 10/2013 a total of 965 TURPs with bipolar or monopolar resection were performed in our department. Patients with known prostate cancer (PC) confirmed by biopsy and patiens with clinically obvious tumor mass by digital rectal examination (DRE) before the procedure were excluded from the study. We collected folowing parameters: total and free prostate specific antigen (tPSA and fPSA) levels, prostate size, number of prostate biopsies and DRE finding before TURP, weight of the resected tissue and Gleason score (GS). We also focused on a treatment modality and if the standard biopsy was performed after TURP with incidental PC. RESULTS: A total of 71 patients (7,36%) were diagnosed with PC after TURP. Mean age was 71,8 (5786) years. Mean PSA level was 5,26 (0,29-64) ng/ml. A total of 57, 10 and 4 patients were diagnosed with GS ≤ 6, 7 and ≥ 8, respectively. Alltogether 15 patients underwent prostate biopsy prior to the surgery with no signs of tumor in histological examination. From the different treatment modalities 12 patients underwent radical radiotherapy (mean PSA 4,73 ng/ml), 5 radical prostatectomy (mean PSA 3,43 ng/ml) and 6 patients hormonal therapy or orchiectomy (mean PSA 20,46 ng/ml). A total of 36 patients were indicated to watchfull waiting (mean PSA 3,7 ng/ml). Only in eight patients a confirmation biopsy was indicated after TURP. Higher GS in this rebiopsy comparing to TURP was found it two of these cases. CONCLUSIONS: There is no strong data suggesting a standardized management of patients with prostate cancer diagnosed incidentally by TURP. We suggest that every patient should undergo confirmation biopsy before potential watchfull waiting. The work was supported by the grant MPO TIP FR-TI3/666. Eur Urol Suppl 2014; 13(6) e1276