Analysis of the risk factors for incidental carcinoma of the prostate in patients with benign prostatic hyperplasia

Authors

  • Alberto Azoubel Antunes São Paulo University Medical School; Division of Urology
  • Geraldo de Campos Freire São Paulo University Medical School; Division of Urology
  • Domingos Aiello Filho São Paulo University Medical School; Division of Urology
  • José Cury São Paulo University Medical School; Division of Urology
  • Miguel Srougi São Paulo University Medical School; Division of Urology

DOI:

https://doi.org/10.1590/S1807-59322006000600010

Keywords:

Benign prostatic hyperplasia, Prostatectomy, Prostate-specific antigen, Prostatic neoplasms

Abstract

PURPOSE: To determine the occurence of incidental carcinoma of the prostate, its characteristics, and the risk factors for this diagnosis in a group of patients surgically treated for benign prostatic hyperplasia. METHODS: The study comprised a retrospective analysis of 218 patients. After surgical treatment, patients with the finding of incidental carcinoma of the prostate were compared to those without this finding. The preoperative variables analyzed were patient age, digital rectal examination, PSA, PSA density, prostate volume, and preoperative prostate biopsy. We also determined the sensitivity, specificity, positive predictive value, and negative predictive value of digital rectal examination and PSA for the finding of incidental carcinoma of the prostate at surgical specimen analysis. RESULTS: Thirteen (6.2%) out of the 218 patients presented incidental carcinoma of the prostate. Eight (61.5%) of these tumors were classified as T1a and 5 (38.5%) as T1b. Only advanced age (P = 0.003) and the presence of a suspect digital rectal examination (P = 0. 016) were statistically related to the findings of the surgical specimen analysis. The sensitivity, specificity, positive predictive value, and negative predictive value for the diagnosis of incidental carcinoma were 23.0%, 96.6%, 30.0%, and 95.2% for a suspect digital rectal examination and 85.0%, 34.1%, 7.5%, and 97.2% for a PSA greater than 4.0 ng/mL. The accuracy for these methods was 92.2% and 37.1%, respectively. CONCLUSIONS: Advanced age and the presence of a suspect digital rectal examination represent the most important risk factors for the diagnosis of an incidental carcinoma of the prostate. However, the low positive predictive values reflect the weak correlations among these variables.

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Published

2006-01-01

Issue

Section

Clinical Sciences

How to Cite

Analysis of the risk factors for incidental carcinoma of the prostate in patients with benign prostatic hyperplasia . (2006). Clinics, 61(6), 545-550. https://doi.org/10.1590/S1807-59322006000600010