Reyes-Sánchez EA, Reyes AJE, Rodríguez SY, Rendón MME, Acevedo GC, Jaspersen GJ

Language: Spanish
References: 14
Page: 1-9
PDF size: 188.91 Kb.

ABSTRACT

Objective: To evaluate the rate of early detection of transition zone prostate cancer through transurethral resection of the prostate (TURP) in patients suspected of having cancer, with or without a negative transrectal biopsy of the prostate (TRBP).
Materials and methods: A retrospective and cross-sectional study evaluated the efficacy of TURP in the early detection of transition zone prostate cancer. The analysis included male patients over 40 years of age that sought medical attention due to lower urinary tract symptoms, elevated prostate-specific antigen, normal digital rectal examination, and negative TRBP, as urology consultation outpatients at the Hospital General de México.
Results: In the group of patients at high risk for prostate cancer that underwent TRBP, 121 (96.03%) had a negative prostate cancer diagnosis after turp. Another 5 (3.97%) patients had a positive prostate cancer diagnosis after TURP, even though the previous transrectal biopsy was negative. Two patients (40%) had a Gleason score of 6, and one patient (20%) had a Gleason score of 7, one patient (20%) had a score of 9, and one patient (20%) had a score of 10. In the group of patients at low risk for prostate cancer that were not candidates for TRBP, but that presented with lower urinary tract symptoms, 111 (88.09%) had a negative prostate cancer diagnosis after turp. An additional 15 (11.91%) had a positive prostate cancer diagnosis after TURP, 7 (46.7%) of whom had a Gleason score of 7, 3 (20%) had a Gleason score of 6, 3 (20%) had a score of 9, one (6.7%) had a score of 8, and one (6.7%) had a score of 10.
Conclusions: Patients detected with prostate cancer through turp represent a diverse group in whom the procedure can be both diagnostic and therapeutic. Our study showed it to be a useful diagnostic tool that can improve prostate cancer detection in isolated and specific cases. However, it should be emphasized that turp alone, performed solely for diagnostic purposes, is not recommended.

REFERENCES

1. Trilla E, Morote J. Cáncer de próstata: nuevas técnicas diagnósticas. Estado actual de la biopsia de próstata. Archivos Españoles de Urología (Ed impresa). 2006;59(10):945–52. [accessed 17 Sep 2019] Available from: http://scielo.isciii. es/scielo.php?script=sci_abstract&pid=S0004- 06142006001000002&lng=es&nrm=iso&tlng= es

2. McNeal J. Pathology of benign prostatic hyperplasia. Insight into etiology. Urol Clin North Am. 1990;17(3):477–86.

3. GLOBOCAN. Cancer today - Mexico. 2019. [accessed 17 Sep 2019] Available from: http:// gco.iarc.fr/today/home

4. Epstein JI. Patología de las neoplasias prostáticas. In: Campbell-Walsh Urologia. México D.F.: Ed. Médica Panamericana; 2015. p. 2748–56.

5. Catalona WJ, Han M. Tratamiento definitivo del cáncer de próstata localizado. Generalidades. In: Campbell-Walsh Urologia. México D.F.: Ed. Médica Panamericana; 2015. p. 2793–810.

6. NCCN. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) Prostate Cancer. Plymouth: NCCN; 2019. 117 p.

7. Loeb S, Ballentine-Carter H. Detección temprana, diagnóstico y estadificación del cáncer de próstata. In: Campbell-Walsh Urologia. México D.F.: Ed. Médica Panamericana; 2015. p. 2785–92.

8. Kim DK, Kim SJ, Moon HS, Park SY, Kim YT, Choi HY, et al. The Role of TURP in the Detection of Prostate Cancer in BPH Patients with Previously Negative Prostate Biopsy. Korean J Urol. 2010;51(5):313–7. doi: https:// doi.org/10.4111/kju.2010.51.5.313

9. Yates DR, Gregory GC, Roupret M, Malki MM, Haynes MD, Hamdy FC, et al. Transurethral resection biopsy as part of a saturation biopsy protocol: a cohort study and review of the literature. Urol Oncol. 2013;31(5):542–8. doi: https://doi.org/10.1016/j.urolonc.2011.02.008

10. Zigeuner R, Schips L, Lipsky K, Auprich M, Salfellner M, Rehak P, et al. Detection of prostate cancer by TURP or open surgery in patients with previously negative transrectal prostate biopsies. Urology. 2003;62(5):883–7. doi: 10.1016/s0090-4295(03)00663-0

11. van Renterghem K, van Koeveringe G, Achten R, van Kerrebroeck P. Clinical relevance of transurethral resection of the prostate in ‘asymptomatic’ patients with an elevated prostate-specific antigen level. Eur Urol. 2007;52(3):819–26. doi: https://doi. org/10.1016/j.eururo.2007.03.055

12. van Renterghem K van, van Koeveringe G van, Achten R, van Kerrebroeck P van. Long-Term Clinical Outcome of Diagnostic Transurethral Resection of the Prostate in Patients with Elevated Prostate-Specific Antigen Level and Minor Lower Urinary Tract Symptoms. UIN. 2009;83(1):60–5. [accessed 17 Sep 2019] Available from: https://www.karger.com/ Article/FullText/224870

13. Cho HJ, Shin SC, Cho JM, Kang JY, Yoo TK. The role of transurethral resection of the prostate for patients with an elevated prostatespecific antigen. Prostate Int. 2014;2(4):196– 202. [accessed 17 Sep 2019] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC4286732/

14. Mai KT, Isotalo PA, Green J, Perkins DG, Morash C, Collins JP. Incidental prostatic adenocarcinomas and putative premalignant lesions in TURP specimens collected before and after the introduction of prostratespecific antigen screening. Arch Pathol Lab Med. 2000;124(10):1454–6. doi: https://doi. org/10.1043/0003-9985(2000)124%3C1454:IP AAPP%3E2.0.CO;2