[Watchful waiting in incidental adenocarcinoma of the prostate].

OBJECTIVE

To describe the outcome of patients diagnosed of incidental prostate adenocarcinoma managed by watchful waiting.

MATERIAL AND METHODS

We included patients with PSA< 4 ng/mL or higher with previous negative biopsy, who underwent surgery for BPH being diagnosed of incidental prostate adenocarcinoma. We performed a descriptive and retrospective study in patients with this diagnosis between 1992 and 2007. Salvage curative treatment was offered to those patients who progressed. Statistical analysis was performed using SPSS program. Progression variables were: age, preoperative and postoperative PSA, stage, Gleason score, prostate volume, initial treatment, PSA evolution and salvage treatment if necessary.

RESULTS

47 patients were diagnosed of incidental prostatic adenocarcinoma, finding an incidence of 4.25%. The medium follow up was 37 months. Of the patients who opted for watchful waiting, 72.5% remain on it. 11 patients progressed. Postoperative PSA and Gleason score showed up as prognostic variables of progression in T1a stage and postsurgery PSA did so in T1b patients.

CONCLUSION

Watchful waiting is a useful option in patients with incidental prostate adenocarcinoma and favourable prognostic criteria. Postoperative PSA and Gleason score can predict progression in T1a stage and postoperative PSA in T1b stage.