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Evaluation of Factors Associated with the Detection of Incidental Prostate Cancer after Open Prostatectomy for Benign Prostatic Hyperplasia
  • +10
  • Yalcin Kizilkan,
  • Samet Senel,
  • Melih Balci,
  • Mehmet Yıldızhan,
  • Ibrahim Can Aykanat,
  • Unsal Eroglu,
  • Binhan Kagan Aktas,
  • Suleyman Bulut,
  • özer güzel,
  • Cevdet Serkan Gokkaya,
  • Yılmaz Aslan,
  • Cüneyt Özden,
  • Altug Tuncel
Yalcin Kizilkan
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Samet Senel
Ankara City Hospital

Corresponding Author:[email protected]

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Melih Balci
Ankara City Hospital
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Mehmet Yıldızhan
Ankara City Hospital
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Ibrahim Can Aykanat
Yozgat State Hospital
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Unsal Eroglu
Ankara City Hospital
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Binhan Kagan Aktas
Ankara City Hospital
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Suleyman Bulut
Ankara City Hospital
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özer güzel
Ankara City Hospital
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Cevdet Serkan Gokkaya
Ankara City Hospital
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Yılmaz Aslan
University of Health Sciences Gülhane Health Sciences Institute
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Cüneyt Özden
Ankara City Hospital
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Altug Tuncel
Ankara City Hospital
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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.