Incidental carcinoma of the prostate: histopathology and natural history

We reviewed 60 cases of incidental carcinoma of the prostate treated conservatively. Subclassification of incidental carcinoma was based on histologic grade and tumor size. Stage A1 was defined as a low grade (grade I) and focal lesion, and stage A2 as a high grade (grade II, III) or diffuse lesion. The distinction between focal and diffuse was set at three chips in a transurethrally resected specimen or a diameter of 5 mm for a total lesion in an enucleated specimen. Patients with stage A1 tumors did significantly better (p less than 0.05) than those with A2, the 5-year survival rates being 88% and 70%, respectively. It is believed that patients with stage A2 should be treated aggressively. However, conservative therapy is recommended for the patients with stage A1 prostate cancer.