Incidental prostate cancer after transurethral resection of the prostate: analysis of incidence and risk factors in 458 patients

BACKGROUND: To evaluate the incidence and risk factors of incidental prostate cancer (IPCA) in a contemporary cohort of lower urinary tract symptoms (LUTS) patients who underwent trans-urethral resection of the prostate (TURP).METHODS: A series of 458 consecutive patients who underwent TURP were evaluated between January 2016 to June 2018. Evaluated factors included age (years), body mass index (BMI; kg/square meters), treatment with inhibitors of 5-alpha reductase, previous prostate biopsies, basal prostate specific antigen (PSA) levels (ng/mL), serum leukocyte count (n*10^9/L), weight of resected prostate tissue (grams), grade and stage of IPCA. The multivariate logistic regression model evaluated associations of significant clinical factors with the risk of IPCA.RESULTS: Overall, IPCA was detected in 30 out of 454 patients (6,6%). A mean of 21,8 grams of tissue was resected. The mean number of positive chips was 5,6 (mean percentage 3,9%) with tumor grade group 1 in 22 cases (73,4%) and tumor stage cT1a in 23 patients (76,7%). On multivariate analysis, independent factors that were positively associated with the risk of IPCA were BMI (odds ratio, OR = 1,121; p = 0,017) and leukocyte count (OR = 1,144; p = 0,027).CONCLUSIONS: In a contemporary cohort of patients undergoing TURP for the treatment of LUTS, the risk of IPCA was not negligible with a rate of being 6,6%. BMI and serum leukocyte count were found to be independent factors that were positively associated with the risk of IPCA.