Incidental prostate cancer after holmium laser enucleation of the prostate: Critical analysis of independent risk factors and impact on surgical outcomes

Autor: Joao G. Porto, Ruben Blachman‐Braun, Tarek Ajami, Mohamadhusni Zarli, Ryan Chen, Thiago Furtado, Robert Marcovich, Dipen J. Parekh, Hemendra N. Shah
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: BJUI Compass, Vol 5, Iss 3, Pp 374-381 (2024)
Druh dokumentu: article
ISSN: 2688-4526
DOI: 10.1002/bco2.306
Popis: Abstract Objectives The objectives of this study are to evaluate the impact of incidental prostate cancer (iPCa) and its different grade group (GG) on the surgical outcomes of holmium laser enucleation of the prostate (HoLEP) and, furthermore, to assess the independent risk factors associated with the detection of iPCa. Patients (or materials) and Methods A retrospective chart review was conducted at a single institution for HoLEP cases that were performed between 2017 and 2022. Patients with a preoperative diagnosis of prostate cancer and those without baseline prostate‐specific antigen (PSA) levels within 1 year were excluded. Four hundred seventeen patients were divided into three groups: benign prostatic hyperplasia—377; clinically insignificant (GG 1)—29; and clinically significant prostate cancer (GG 2–5)—11. The preoperative parameters analysed included age, body mass index, race/ethnicity, use of 5‐alpha‐reductase inhibitors, PSA, prostate size, PSA density, and history of negative prostate biopsy. To evaluate the association between clinical and demographic variables, a multivariable‐adjusted logistic regression analysis was performed. We also assessed intraoperative and post‐operative outcomes among these three groups. Results A total of 417 patients were analysed; 40 (9.6%) patients had iPCa, of which 29 (72.5%) and 11 (27.5%) were clinically nonsignificant and significant prostate cancer, respectively. Of all the demographic and preoperative variables analysed, hypertension was significantly associated with overall prostate cancer diagnosis (p
Databáze: Directory of Open Access Journals