Implications for the Treatment of Patients with Incidental Prostate Cancer Discovered by a Partial Prostatectomy for the Treatment of Presumed Benign Prostate Enlargement (BPH)
This study focused on men in Denmark who had a surgery called TURP (transurethral resection of the prostate), which is often done to treat problems with urination. Sometimes during this surgery, doctors discover prostate cancer, even though the patients didn’t have a previous cancer diagnosis. The researchers wanted to understand what happens to these men over time, especially those with low-risk (Grade Group 1) and intermediate-risk (Grade Group 2) prostate cancer. They analyzed data from over 24,000 patients who underwent a TURP between 2006 and 2022. Of these men, 1,016 had Grade Group 1 prostate cancer, while 381 had Grade Group 2. Over the next five years, about 36% of the GG1 group and 30% of the GG2 group underwent further tests, such as MRI scans or additional biopsies, to monitor their cancer. After 15 years, 8.4% of the men with GG1 and 14% of those with GG2 had died from prostate cancer. However, the risk of dying was significantly lower for men whose follow-up biopsy after the TURP showed no remaining cancer, 0.6% died after 15 years. In contrast, men who had a follow-up biopsy indicating more serious cancer (Grade Group 2 or higher) experienced a much higher death rate of 30%. The study shows that even when prostate cancer is found by accident during surgery like TURP, it should not be ignored. Some men may have a more aggressive cancer that wasn’t picked up the first time, especially in areas of the prostate that TURP doesn’t reach well. The researchers suggest that patients with incidental prostate cancer need further testing to find out if their cancer is more serious. But if follow-up testing shows no signs of cancer, those patients might not need as much ongoing monitoring, like men whose first biopsy was completely normal.
J Urol. 2024 Nov;212(5):692-700. doi: 10.1097/JU.0000000000004159. Epub 2024 Jul 31. PMID: 39083481.
