The pathologic features and prognosis of different treatment for incidental prostate cancer
Objective To investigate the pathologic features and prognosis of different treatment for incidental prostate cancer.Methods The clinical data of 2 427 cases of Benign prostatic hyperplasia(BPH)undergoing transurethral resection of prostste were analyzed retrospectively in the Department of Urology,PLA General Hospital from January 2007 to December 2021.Postoperative pathological diagnosis revealed prostate cancer in 54 cases,with an incidence rate of 2.2％.The mean patient's age was(72.3± 7.2)years old,the median value of body mass index(BMI)was 24.8(23.1,26.6)kg/m2,the median value of total prostate specific antigen(tPSA)before operation was 5.7(3.2,11.1)ng/ml,and the median value of prostate volume was 60.1(38.0,88.6)ml.Results Among the 54 cases,Gleason scoring was not performed in one case,and the median value of Gleason score was 6(6,7).According to the WHO/ISUP grade group(GG),58.5％(31/53)were assigned to grade 1,18.9％(10/53)to grade 2,13.2％(7/53)to grade 3,1.9％(1/53)to grade 4,and 7.5％(4/53)to grade 5.Forty-five patients were followed up,and the median follow-up time was 57(34.5,94.5)months.Among them,14 patients underwent active surveillance(AS),15 patients were treated with androgen deprivation therapy(ADT),11 patients were treated with RP,one patient was treated with radioactive seed implantation,and 4 patients underwent watchful waiting.Among 11 patients who underwent radical prostatectomy,pathological examination indicated that all surgical margins were negative,with no evidence of nerve invasion,extracapsular extension,seminal vesicle involvement,or lymph node metastasis.BMI in AS,ADT and RP groups were(26.9±4.9)kg/m2,(24.4±4.1)kg/m2and(24.5±1.4)kg/m2,the preoperative PSA were(6.3±4.2)ng/ml,(9.4±7.6)ng/ml and 6.4(3.8,11.6)ng/ml,GG 1 were 10/14 cases,47/15 cases and7/11 cases,GG 2 were 3/14 cases,2/15 cases and 3/11 cases,GG 3 were 1/14 cases,3/15 cases and 1/11 cases,and GG 4-5 were 0/14 cases,3/15 cases and 0/11 cases.The differences had no statistically significance(P＞0.05).The ages in AS,ADT and RP groups were(71.2±6.6)years,(75.3±7.4)years and(66.6±4.7)years,which had statistically significance(P=0.007).Kaplan-Meier survival analysis showed that the cumulative survival rates within 5 years in AS,ADT and RP groups were 92.9％,86.7％and 100.0％,which had no statistically significance(P=0.291).The 5-year tumor progression(recurrence)rates and tumor specific mortality rates were 8.7％and 2.2％for incidental prostate cancer.Conclusions Most of incidental prostate cancers were assigned to GG 1,and the 5-year tumor progression(recurrence)rates and tumor specific mortality rates of incidental prostate cancer were low.There is no significant difference in the prognosis with AS,ADT and RP for incidental prostate cancer.
万方数据
维普
