[Determination of prognostic factors in incidental prostatic carcinoma]

Over a ten year period, 5,954 patients with benign prostatic hyperplasia (BPH) were hospitalized in our Institution. Of these, 1,000 cases were randomly chosen for the present study. Surgery was performed in 930 patients: transurethral resection (TUR) in 665 (72%) and open prostatectomy in 265 (28%). The pathological analyses revealed prostatic adenocarcinoma in 36 patients (4%). Seven patients were excluded: 5 due to a short follow-up (less than one year), one who had died from pulmonary embolism immediately postoperatively and one who had developed metastatic disease a few months after the operation. The age of the 29 evaluable patients ranged from 53 to 91 years (mean 72.7 years) and the overall mean follow-up was 43 months. Eighteen patients staged A1 were treated conservatively and followed from 12 to 127 months (mean 53.5 months). Two patients (11%) showed progression, one locally at 42 months (5.5%) and one developed bone metastasis at 15 months (5.5%) and died at 27 months (Mortality: 5.5%). Of the eleven patients with stage A2 prostatic cancer, 7 were managed conservatively (watchful waiting), 1 underwent radical prostatectomy and 3 received early hormone therapy for undifferentiated lesions. Five patients progressed (45%), including the three patients treated with early hormone therapy, 3 local (27%) and 2 systemic (18%). Two of the 11 patients died from cancer (18%) and 2 from unrelated causes. The Gleason grading system and tumor volume (focal or diffuse) were compared as prognostic factors using the Kaplan-Meyer and log-rank test.(ABSTRACT TRUNCATED AT 250 WORDS)