Frequency of Incidental Prostatic Carcinoma in Transurethral Resection Biopsies

Background: Incidental prostate malignancy can be detected in men who are undergoing transurethral resection of the prostate for nodular hyperplasia. Consequently, it is crucial to thoroughly assess the transurethral resection specimen for precise diagnosis, grading, and staging.
Objectives: To investigate the frequency of prostate cancer incidentally discovered in transurethral resection specimens and to ascertain its correlation with some clinicopathological factors.
Methods: This study included 200 patients who had undergone transurethral resection of the prostate for the treatment of nodular prostatic hyperplasia between January 2020 and January 2023. Patients' age, prostate-specific antigen serum levels, and the resected prostate weight were assessed. Additionally, tumor stage, Gleason grade group, perineural invasion, and lymphovascular status were evaluated in the prostate cancer group. Statistical analysis was done to investigate the relationship between these parameters and the detection of prostate cancer.
Results: The study revealed an incidental detection rate of prostate cancer at 11.5%. This group exhibited notably higher average ages and prostate-specific antigen levels than the nodular prostatic hyperplasia group. Furthermore, the weight of the removed specimen influenced the detection rate of incidental prostate cancer. Out of the 23 identified cases of incidental prostate cancer, 17 (73.9%) were categorized as stage T1b. Statistically significant disparities were observed among the T1 stages concerning prostate-specific antigen levels and the weight of the excised specimen.
Conclusions: This study demonstrates a rise in the frequency of unsuspected prostate cancer following transurethral resection of presumed nodular prostatic enlargement in Nineveh province. Most of these neoplasms were of the high-grade group, indicating a higher likelihood of clinical significance. Precise histopathological assessment of all transurethral resection of prostate specimens might enhance the possibility of detecting incidental cancer in nodular prostate hyperplasia.