Departments of Urology Biomedical Statistics and Informatics, Mayo Clinic, Phoenix, Arizona85054, USA.
Int J Urol. 2011 Jul;18(7):543-7. doi: 10.1111/j.1442-2042.2011.02776.x. Epub 2011 May 18.
Incidental prostate cancer (PCa) after treatment of benign prostate hyperplasia (BPH) is becoming less common. This is a result of the changing patterns of BPH treatment. The purpose of the present research was to re-examine the clinical outcomes and importance of cT1a and cT1b PCa in a contemporary cohort after holmium laser enucleation of the prostate (HoLEP). All patients with newly diagnosed PCa after HoLEP were retrospectively identified. Pre- and postoperative prostate-specific antigen (PSA), biopsy history, pathological features and disease progression were examined. Patients were matched to a control group with benign pathology for outcome comparisons. The database consisted of 240 consecutive patients, aged 52-90 years with prostate sizes from 25 to 375 cm(3) . A total of 28 patients were identified with incidental PCa (14 cT1a and 14 cT1b). Median follow up was 11 months and 13 months for cT1a and cT1b, respectively. Hospitalization time, catheterization time, complications and functional outcomes were similar. Three patients with cT1b required additional treatment as a result of PSA progression. All other cancers are being closely followed. The functional benefits of HoLEP are well established. The incidental PCa detection rate of 11.7% shows the potential benefit of pathological analysis. Just 10.7% of these patients received additional treatment, but this might be significant as these patients would otherwise go untreated. The impact on disease-specific survival and progression requires a longer follow up.
经前列腺增生 (BPH) 治疗后偶发前列腺癌 (PCa) 的情况越来越少见。这是 BPH 治疗模式变化的结果。本研究旨在重新评估钬激光前列腺剜除术 (HoLEP) 后当代队列中 cT1a 和 cT1b PCa 的临床结果和重要性。回顾性分析了所有经 HoLEP 治疗后新诊断为 PCa 的患者。检查了术前和术后前列腺特异性抗原 (PSA)、活检史、病理特征和疾病进展情况。将患者与良性病理对照组进行匹配，以进行结果比较。该数据库包括 240 例连续患者，年龄 52-90 岁，前列腺体积为 25-375 cm(3)。共发现 28 例偶发性 PCa（14 例 cT1a 和 14 例 cT1b）。cT1a 和 cT1b 的中位随访时间分别为 11 个月和 13 个月。住院时间、导尿时间、并发症和功能结果相似。由于 PSA 进展，3 例 cT1b 需要额外治疗。所有其他癌症都在密切随访中。HoLEP 的功能获益已得到充分证实。偶然发现的 PCa 检出率为 11.7%，表明病理分析具有潜在的获益。只有 10.7%的患者接受了额外的治疗，但这可能是重要的，因为否则这些患者将得不到治疗。对疾病特异性生存和进展的影响需要更长时间的随访。
