Mp09-06 Incidental Prostate Cancer in Patients Treated for Benign Prostatic Hyperplasia: Analysis From a Contemporary National Dataset

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Epidemiology, Evaluation & Medical Non-surgical Therapy (MP09)1 May 2024MP09-06 INCIDENTAL PROSTATE CANCER IN PATIENTS TREATED FOR BENIGN PROSTATIC HYPERPLASIA: ANALYSIS FROM A CONTEMPORARY NATIONAL DATASET Eugenio Bologna, Antonio Franco, Leslie Claire Licari, Francesco Ditonno, Celeste Manfredi, Morgan Sturgis, Cosimo De Nunzio, Alessandro Antonelli, Costantino Leonardo, Marco De Sio, Srinivas Vourganti, Christopher Coogan, Edward E. Cherullo, and Riccardo Autorino Eugenio BolognaEugenio Bologna , Antonio FrancoAntonio Franco , Leslie Claire LicariLeslie Claire Licari , Francesco DitonnoFrancesco Ditonno , Celeste ManfrediCeleste Manfredi , Morgan SturgisMorgan Sturgis , Cosimo De NunzioCosimo De Nunzio , Alessandro AntonelliAlessandro Antonelli , Costantino LeonardoCostantino Leonardo , Marco De SioMarco De Sio , Srinivas VourgantiSrinivas Vourganti , Christopher CooganChristopher Coogan , Edward E. CherulloEdward E. Cherullo , and Riccardo AutorinoRiccardo Autorino View All Author Informationhttps://doi.org/10.1097/01.JU.0001008920.55771.18.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prostate cancer (PCa) can be incidentally detected at histopathological analysis following surgery for benign prostatic hyperplasia (BPH). This study aims to analyze the incidence and trends of incidental PCa (iPCa) among patients undergoing BPH surgery and to evaluate its management. METHODS: A retrospective analysis was conducted using the extensive PearlDiver™ Mariner database, containing de-identified patient records (over 41 billion) compiled between 2011 and 2022, in compliance with the Health Insurance Portability and Accountability Act (HIPAA). International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) codes were employed to identify population and outcomes. We considered BPH treatments resulting in histological examination: TURP, HoLEP/ThuLEP and Simple Prostatectomy (open and minimally invasive). The primary objective was to determine the overall incidence of iPCa and its association with different surgical approaches. Furthermore, we investigated trends of prostate biopsies and magnetic resonance imaging (MRI) prior to BPH treatments over the years using linear regression analysis. Patients age, comprehensive and procedure-specific iPCa diagnoses, number of preoperative biopsies and pelvic MRIs and the therapeutic courses adopted after iPCa diagnosis were collected. RESULTS: Among a total of 231.626 procedures analyzed, 5.090 patients (2.20%) were diagnosed with iPCa at a mean age of 71.72 years. Within 6 months before surgery, a preoperative biopsy or MRI was performed in 6.55% and 3.90% of patients, respectively. Overall, a significant decrease in preoperative biopsy rates was observed (p-value<0.001), while the use of preoperative MRI displayed an upward trend (p-value=0.002). Preoperative prostate biopsy was identified as a risk factor for diagnosing iPca, while MRI appears to mitigate this risk; however, neither reaches statistical significance. Furthermore, none of the different BPH procedures demonstrated a higher risk of iPCa diagnosis. No significant variations in rates of iPCa could be observed. A small percentage of patients (4.15%) received treatments for iPCa, including radical prostatectomy (0.53%), radiotherapy (0.12%) and ADT (3.50%). Most patients (95.85%) did not receive active treatment for iPCa. CONCLUSIONS: There are several interesting findings from the present analysis. In general, the incidence of iPCa is very low (less than 3%) and remains stable over the years. None of the BPH procedures seems to be associated with a higher incidence of iPCa. An increase in the use of preoperative MRI in patients undergoing BPH surgery is accompanied by a concomitant decrease in rates of preoperative biopsies. Approximately 95% of patients with iPCa do not undergo active treatment. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e128 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Eugenio Bologna More articles by this author Antonio Franco More articles by this author Leslie Claire Licari More articles by this author Francesco Ditonno More articles by this author Celeste Manfredi More articles by this author Morgan Sturgis More articles by this author Cosimo De Nunzio More articles by this author Alessandro Antonelli More articles by this author Costantino Leonardo More articles by this author Marco De Sio More articles by this author Srinivas Vourganti More articles by this author Christopher Coogan More articles by this author Edward E. Cherullo More articles by this author Riccardo Autorino More articles by this author Expand All Advertisement PDF downloadLoading ...