Prostate cancer after surgery for benign prostatic hyperplasia

Ristovski, Slobodan and Sofronievska, Maja and Sosolceva, Mirjana (2021) Prostate cancer after surgery for benign prostatic hyperplasia. Macedonian Journal of Anaesthesia, 5 (23). pp. 11-19. ISSN 2545-4366

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Abstract

ABSTRACT
Objective: To determine the incidence and characteristic of prostate cancer in patients with
previous BPH surgery.
Materials and Method: In a retrospective study between 2002 and 2015, we analyzed
patients who developed prostate cancer after surgery for BPH. Patients were examined by age,
prostate volume, IPSS score, type and duration of the drug therapy, PSA values before and three
months after surgery and the type of BPH surgery. In patients with prostate cancer, we estimated
the time between BPH surgery and the occurring of cancer, Gleason score, TNM stage, type
of therapy and survival. Follow-up for BPH patients was 3 months, and for the prostate cancer
(PCa) group it was five years. Cox regression was used to determine the influence of various
variables on the incidence of prostate cancer after BPH surgery.
Results: Incidence of prostate cancer was 1.69% (9 of 532 BPH surgeries) and was diagnosed
significantly (p<0.001) more in patients who underwent open prostatectomy versus TURP. The
mean time between BPH surgery and diagnosis of prostatic cancer was 7.2 years and did not
correlate with investigated parameters. The value of IPSS in the BPH group was significantly
higher compared to before PCa surgery (p=0.012). In the PCa group, PSA values decreased
from 2.30±0.83 to 0.95±0.38ng/ml after three months and in the BPH group from 1.98±0.84 to
0.54±0.33ng/ml. PSA reduction rate for the PCa group was 58.4±11.6% versus 70.7±0.58% in
the BPH group. In the Age-adjusted analysis, the PSA reduction rate was 0.050(0.001-0.937)
HR (CI). In the PCa group, the serum PSA levels were 6.5 times increased (mean 14.97ng/ml)
(p=0.001) compared to the BPH group. Before BPH surgery, the mean prostate volume was 60,
4 ccm, 5.3 ccm greater than in the cancer group. Two PCa patients had bone metastases. Radical
prostatectomy was performed in 5 cases and four were treated with LHRH agonists and antiandrogens. One died three years after PCa diagnosis.
Conclusions: PSA reduction rate was borderline significant predictors of prostate cancer
after BPH surgery.
KeyWords: benign prostate hyperplasia, open prostatectomy, prostate cancer, PSA reduction
rate, TURP.

Item Type:	Article
Subjects:	Medical and Health Sciences > Basic medicine Medical and Health Sciences > Clinical medicine Medical and Health Sciences > Health sciences Medical and Health Sciences > Other medical sciences
Divisions:	Faculty of Medical Science
Depositing User:	Maja Sofronievska
Date Deposited:	15 Aug 2022 09:18
Last Modified:	15 Aug 2022 09:18
URI:	https://eprints.ugd.edu.mk/id/eprint/29975

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