Successful Treatment of Incidental Prostate Cancer by Radical Transurethral Resection of Prostate Cancer

It often seems difficult to decide how to manage patients with incidental prostate cancer. We analyzed our patients who underwent radical transurethral resection of prostate cancer (RTUR-PCa) and obtained satisfactory results that suggested RTUR-PCa could be an option for radical treatment against incidental cancer. Background: To evaluate the rationale for RTUR-PCa against pT1a/b cancer, we analyzed oncological and functional outcomes. Patients and Methods: Fifty-six patients with incidental prostate cancer were included and the age ranged from 66 to 91 years (mean, 76.6; median, 75.0). Preoperative prostate specific antigen (PSA) levels were between 0.70 and 44.1 ng/mL (mean, 5.90; median, 4.60). We performed 69 RTUR-PCa's by resecting and fulgurating the residual prostate tissues after previous transurethral resection of the prostate. Prostate specific antigen non-recurrence rate was calculated by Kaplan-Meier method. Results: Follow-up duration of 51 patients was mean +/- SD 64.1 +/- 21.6 months (median, 67.8 months; range, 13.8-99.8) excluding 5 patients that were lost to follow-up. Prostate specific antigen failure developed in 3 patients (5.9%). In the other 48 patients, PSA stabilized as follows: PSA <= 0.01, 24 cases; <= 0.02, 5 cases; <= 0.03, 6 cases; <= 0.04, 3 cases; <= 0.1, 7 cases; and <= 0.4, 3 cases. Prostate specific antigen nonrecurrence rates were 100% for pT2a and 91.3% for pT2b at the mean follow-up period of 64.1 months. Nonrecurrence rate grouped by D'Amico classification system were 100% in the low-risk group, 94.7% in the intermediate-risk group, and 88.2% in the high-risk group, respectively. Water intoxication did not develop and no patients required transfusion. Bladder neck contracture, which developed in 22 out of 51 patients (43.1%), was the most frequent postoperative complication. Postoperative incontinence was temporary and disappeared within 3 months in all patients. Conclusion: Satisfactory oncologic and functional results suggest that RTUR-PCa could be a promising option for radical treatment against incidental prostate cancer. (C) 2013 Elsevier Inc. All rights reserved.