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Incidental adenocarcinoma after open prostatic adenectomy
T J Stillwell1, R S Malek, D E Engen
1Department of Urology, Mayo Clinic, Rochester, Minnesota 55905.
The Journal of Urology
|January 1, 1989
Summary
Incidental prostate adenocarcinoma discovered during benign prostate surgery affects 6% of patients. Accurate staging and timely adjuvant therapy are crucial for managing stage A disease and improving outcomes.
Area of Science:
- Urology
- Oncology
- Pathology
Background:
- Prostate adenocarcinoma can be incidentally found during surgery for benign prostatic hyperplasia.
- This incidental finding, known as stage A prostate cancer, requires careful management.
Purpose of the Study:
- To determine the incidence of incidental prostate adenocarcinoma in patients undergoing open prostatic adenectomy.
- To evaluate the outcomes and recommend management strategies for incidentally discovered stage A prostate cancer.
Main Methods:
- Retrospective review of 468 patients who underwent open prostatic adenectomy.
- Pathological examination of enucleated prostate glands for adenocarcinoma.
- Staging of identified tumors (Stage A1 vs. A2) and follow-up for disease progression.
Main Results:
- 28 out of 468 patients (6.0%) had unsuspected prostate adenocarcinoma.
- 14 tumors were initially staged as A1 and 14 as A2; 5 cases were re-staged from A1 to A2 after review.
- Disease progression occurred in 4 patients with stage A2 disease over a mean follow-up of 10.6 years.
Conclusions:
- Accurate pathological review of surgical specimens is essential for correct staging of incidental prostate adenocarcinoma.
- Adjuvant therapy is recommended for all stage A2 cases and for younger stage A1 patients with favorable life expectancies.