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[This article belongs to Volume - 70, Issue - 9]
Published on : 2025-09-11 19:20:15
Article Code: AMJ-11-09-2025-12336
Title : A Single-Center Study on the Prevalence and Predictors of Incidental Prostate Cancer Diagnosed Following Transurethral Resection of the Prostate
Author(s) : Rajiv Mehta, Anjali Desai, Vikram Singh
Abstract :
Background: Many prostate cancers remain undiagnosed until benign prostatic hyperplasia (BPH) surgeries are
performed. Transurethral resection of the prostate (TURP) renders subsequent radical prostatectomy technically
challenging. Therefore, it is advantageous to identify high-risk patients and consider further investigations prior to
BPH surgery. Objectives: This study aims to report the prevalence of incidental prostate cancer (IPC) following TURP
at Penang General Hospital and to develop predictive factors for IPC. Methods: This retrospective observational study
reviewed patients who underwent TURP for presumed BPH over the past five years. Clinicopathological variables
studied included patient age, serum prostate-specific antigen (PSA) level, prostate volume, PSA density, resected
prostatic tissue weight, and histopathological assessment of the resected specimen. Results: A total of 220 patients
underwent TURP for presumed BPH from April 2018 to April 2023. Thirteen patients (5.9%) had IPC, including seven
patients with T1a disease and six patients with T1b disease. The most common cancer detected was ISUP grade group
1 (n = 6), followed by grade groups 2 (n = 4), 3 (n = 2), and 4 (n = 1). Stepwise binary logistic regression analysis
revealed that a PSA density of >0.15 ng/ml² (p = 0.001) and low resected prostatic tissue weight (p = 0.024) correlated
with an increased prevalence of IPC, with odds ratios of 26.1 and 0.9, respectively. Conclusions: The prevalence of
IPC at Penang General Hospital is 5.9%. A PSA density of >0.15 ng/ml² and low resected prostate volume are
associated with a higher risk of IPC following TURP. Patients at risk should be offered further investigations, such as
mpMRI of the prostate and/or repeat prostatic needle biopsy prior to BPH surgeries. Additionally, pathologists should
consider examining the specimens of at-risk patients in their entirety rather than using standard handling procedures.