Evaluation of Factors Associated with the Detection of Incidental
Prostate Cancer after Open Prostatectomy for Benign Prostatic
Hyperplasia
Abstract
Aim: To evaluate the incidental prostate cancer (PCa) rate and
predictive factors in patients who underwent open prostatectomy (OP)
with a pre-diagnosis of benign prostatic hyperplasia (BPH). Methods:
This cross-sectional, retrospective study included patients with a
pre-diagnosis of BPH, who underwent OP due to symptomatic prostate
enlargement. Our database included age, medications, prostate-specific
antigen (PSA), free/total PSA ratio, PSA density, digital rectal
examination (DRE), prostate volume, serum neutrophil/lymphocyte ratio,
platelet/lymphocyte ratio, aspartate aminotransferase (AST)/alanine
aminotransferase (ALT) ratio, presence of metabolic syndrome (MetS), and
histopathological results after OP. Results: Of the 430 patients that
underwent OP with a pre-diagnosis of BPH, 406 (94.4%) with a benign
pathological diagnosis were evaluated as the benign group in and 24
(5.6%) detected to have PCa constituted the incidental PCa group. In
the univariate analysis, age, AST/ALT ratio, MetS, and DRE significantly
differed between the groups (p=0.008, p=0.005, p=0.004 and
p<0.001, respectively). The rate of incidental PCa was much
higher in the elderly patients. The cut-off value of age was 71.5 years
in the PCa group according to the receiver operating characteristic
curve analysis. According to the multivariate analysis, only DRE and
presence of MetS were effective in predicting PCa. DRE was found 16
times more effective and MetS was 2.8 times more effective than the
other parameters. Conclusion: Our results showed that DRE and presence
of MetS can be useful predictive factors of incidental PCa in OP.