TURP in patients with biopsy-proven prostate cancer: sensitivity for cancer detection

Recent laser techniques for the treatment of benign prostatic obstruction result in a significant amount of vaporization. Therefore, less tissue is retrieved for histologic evaluation. This might be an argument in favor of monopolar transurethral resection of the prostate (TURP). The aim of this retrospective study was to determine the ability to detect prostate cancer (PCa) in the TURP specimen of patients with biopsy-proven PCa and to gain information about the value of the TURP specimen during benign prostatic obstruction treatment.

The charts of 154 patients with biopsy-proven PCa who had undergone standard TURP before high-intensity focused ultrasound therapy were retrospectively reviewed. The pre- and postoperative characteristics and histologic features were analyzed to identify the sensitivity of TURP in terms of PCa detection. Patients with incidentally detected PCa or a history of radiotherapy or chemotherapy were excluded. All patients underwent TURP by an experienced surgeon (>1000 procedures). The histologic features were evaluated and the chips completely analyzed for PCa detection. The Mann-Whitney U test and chi(2) test were used for statistical analysis.

Of the 154 patients, 84 fulfilled the inclusion criteria. The mean patient age was 69.8 years (range 59-82). The mean prostate-specific antigen level was 9.8 ng/dL, the mean prostate volume was 31.7 cm(3), and the average amount of resected tissue was 17.9 g. PCa was detected in 45 of 84 patients (54%). No significant differences between the group with histologic findings positive for PCa and the group with negative findings could be found in any of the recorded parameters.

Only 54% of the PCa cases were detected by TURP. Therefore, the worth of the obtained tissue sample during TURP seems questionable.