INCIDENTAL DETECTION OF PROSTATE CANCER IN TRANSURETHRAL RESECTION OF PROSTATE (TURP) SPECIMENS: A RETROSPECTIVE STUDY.

Introduction: Transurethral Resection of Prostate (TURP) is a surgery commonly done for Benign Prostatic Hyperplasia (BPH) which mainly targets the transitional zone of prostate gland.T1a and T1b prostate cancer are diagnosed at the time of transurethral resection of the prostate (TURP) for benign prostatic disease.Prior to the PSA era,up to 27% of prostate cancers were detected incidentally at the time of TURP.With an increase in PSA screening,there has been a decrease in pT1a and pT1b lesions.Methods: A 2-year retrospective analysis of TURP specimens collected between from January 2021 till December 2022 was conducted at the institute of Nephro-Urology Yenepoya Medical College Mangalore.TURP specimens were examined and reported by pathologists. Results: A total of 250 patients belonging to the inclusion criteria were studied.The incidence of occult adenocarcinoma prostate in the study group was 2%.Correlating the age of the patients with the incidence of incidental adenocarcinoma prostate,it was observed that the age group 70 - 79 years had the maximum incidence of incidental adenocarcinoma prostate (13.0%, P-value <0.001). The incidence of adenocarcinoma prostate was found to be inversely proportional to the weight of resected gland, but this was not statistically significant. Conclusion: Even if the preliminary diagnosis of BPH is made, processing of all the TURP specimen especially those obtained from elderly patientsand evaluating pre-operative PSA level are important not to miss any tumour.The age of the patient was a positive predictor for incidence of occult adenocarcinoma prostate.The clinical grading of prostate by DRE however,had no correlation with incidence of occult adenocarcinoma prostate.