Incidental versus manifest prostatic carcinoma

The problem in managing incidental prostatic carcinoma is whether deferred treatment or active therapy should be preferred. Eighty-six consecutive patients with prostatic carcinoma diagnosed at TUR-P during 1979-83 were studied retrospectively. Seventeen of the patients (20%) had incidental prostatic carcinoma. Incidental carcinomas were significantly more well differentiated histologically than manifest carcinomas. The striking difference between incidental and manifest prostatic carcinomas appeared when the clinical course was considered. Only one patient with incidental carcinoma developed symptoms requiring endocrine therapy, against 31 patients with manifest carcinoma (p less than 0.01). It is therefore concluded that the distinction between manifest and incidental prostatic carcinoma is justified and that deferred treatment is sufficient in most patients presenting with incidental prostatic carcinoma at TUR-P.