High Incidence of Incidental Prostate Cancer in Transurethral Resection of Prostate Specimens in China. The Value of Pathologic Review.

OBJECTIVE: To identify the incidence and clinicopathologic features of prostate cancer incidentally detected in patients undergoing transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH), and to estimate the clinical value of pathologic review of all TURP specimens.

STUDY DESIGN: A pathologic review was performed on all TURP specimens for each patient from May 1, 2004, to June 30, 2014, in our institute. A total of 1,024 men (ages 46-98) were identified by pathology specimen. Those with a known diagnosis of prostate cancer prior to TURP (n = 16) were excluded from the analysis. The tumor volume, Gleason score, pathologic stage, serum prostate-specific antigen (PSA) level, and follow-up data were evaluated for those who were found to have prostate cancer.

RESULTS: A total of 87 (8.6%) patients (ages 50-88) were found to have prostate cancer. Significant prostate cancer was found in 25 patients. From May 1, 2004, to May 31, 2009, 30 (6.1%) patients (ages 57-83) were found to have prostate cancer. From June 1, 2009, to June 30, 2014, 57 (11.0%) patients (ages 50-88) were found to have prostate cancer.

CONCLUSION: Our series demonstrates that 8.6% of patients were found to have prostate cancer and that the incidence was increasing in recent years. Even in some patients with T1a disease, the tumors were significant. The pathologic review of TURP specimens is valuable in China.