Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Nov;8(6):1599-1606.
doi: 10.1016/j.euf.2022.03.009. Epub 2022 Mar 19.

Predictors of Unfavorable Pathology in Patients with Incidental (pT1a-T1b) Prostate Cancer

Igor Tsaur  1 , Roderick C N van den Bergh  2 , Timo Soeterik  2 , Anita Thomas  3 , Maximilian P Brandt  3 , Fabio Zattoni  4 , Fabrizio Dal Moro  4 , Alessandro Morlacco  4 , Jeanlou Collavino  4 , Guillaume Ploussard  5 , Christian Surcel  6 , Christian Mirvald  6 , Orel Carmona  7 , Barak Rosenzweig  8 , Christian Ruckes  9 , Tatjana Heisinger  10 , Isabel Heidegger  10 , Giorgio Gandaglia  11 , Robert Dotzauer  3 ; European Association of Urology Young Academic Urologists Prostate Cancer Working Party
Affiliations

Predictors of Unfavorable Pathology in Patients with Incidental (pT1a-T1b) Prostate Cancer

Igor Tsaur et al. Eur Urol Focus. 2022 Nov.

Abstract

Background: Incidental prostate cancer (IPCa) is encountered in 10% of surgical procedures for benign prostatic obstruction (BPO). Identification of patients with underlying detrimental prostate cancer is paramount for tailored treatment decision-making, but guideline recommendations for this setting are lacking.

Objective: To highlight clinical and histological characteristics related to BPO surgery that may predict IPCa with unfavorable pathology.

Design, setting, and participants: We included men with IPCa who underwent radical prostatectomy (RP) in the short term after IPCa diagnosis. Two cohorts were built according to final pathology for the RP specimen: unfavorable pathology (International Society of Urological Pathology [ISUP] grade group [GG] ≥3 and/or ≥pT3a and/or pN1) versus favorable pathology.

Outcome measurements and statistical analysis: We performed multivariate regression analysis for the endpoint, which was unfavorable pathology for the RP specimen. Using the model estimates for prostate-specific antigen (PSA), ISUP GG, age, and prostate volume, we established a model for estimating the risk of unfavorable histopathology.

Results and limitations: Overall, 112 patients were included in the final assessment. On multivariate analysis, PSA (odds ratio [OR] 1.083, 95% confidence interval [CI] 1.003-1.170; p = 0.042), ISUP GG for the specimen from BPO surgery (OR 3.090; 95% CI 1.129-8.457; p = 0.028), and age (OR 1.121, 95% CI 1.026-1.225; p = 0.012) were independent predictors for unfavorable histopathology. On receiver operating characteristic analysis, the area under the curve was 0.751. A novel calculator was developed to predict adverse pathology for men with IPCa. The study is limited by its retrospective design.

Conclusions: For men with IPCa, PSA before surgery for BPO, ISUP GG, and age are independent predictors of unfavorable disease. Our results might improve preoperative risk assessment for patient counseling.

Patient summary: We developed a novel calculator to estimate the risk of underlying detrimental disease in men diagnosed with prostate cancer at surgery for benign prostatic obstruction.

Keywords: Benign prostatic obstruction; Incidental; Predictor; Prostate cancer; Unfavorable pathology.

PubMed Disclaimer