[Treatment of prostatic incidental carcinoma]

Fourteen patients with incidentally diagnosed carcinoma of the prostate were reviewed. The frequency of the incidental prostatic carcinoma in our clinic was approximately 7.3% of 191 patients operated for benign prostatic hypertrophy. Five patients with focal and well differentiated carcinoma (stage A1) were managed expectantly with no treatment. Two patients with focal and moderately differentiated carcinoma (stage A2) and three patients with stage A1 cancer were treated by means of chlormadinone acetate. Total retropubic prostatectomy and pelvic lymph-node dissection was performed in four patients with diffuse prostatic carcinoma (stage A2). No serious complication occurred without minimal stress incontinence in one patient. Three patients had diffuse residual carcinoma in the total prostatectomy specimens. In one of them capsular penetration of carcinoma cells was discovered. Follow up was performed for 1.5-7 years (mean 43 months) by repeated transrectal needle biopsy, bone scan and serum phosphatase. Metastasis and recurrence have not developed in any patient. Two patients died without evidence of cancer. The remaining patients are alive without evidence of disease. Radical operation is recommended for patients with stage A2 prostatic carcinoma after transurethral resection of prostate.