Incidental Adenocarcinoma in Transurethral Resections of the Prostate: Partial Versus Complete Microscopic Examination

Abstract

Transurethral resection of prostate (TURP) for clinically benign prostatic enlargement is a common surgical procedure which often provides voluminous material for microscopic pathology examination. In about 15% of cases, prostate adenocarcinoma will be discovered incidentally in TURP tissue. Many of these incidental carcinomas are stage A1 and require no further clinical intervention, but a significant number of them are stage A2. The question in this study was to ascertain whether all or only a portion of tissue from routine clinically benign TURP specimens must be submitted in order to detect all clinically significant (stage A2) prostatic carcinomas. Results from this prospective study of 457 clinically benign TURPs in which all tissue was processed revealed 65 (14.2%) incidental carcinomas. Statistical analysis by number of blocks of tissue examined revealed that all A2 carcinomas and the large majority of A1 carcinomas would be detected by routine submission of either blocks (average: 12.8 g) of prostate chips. This finding is in close accord with traditional practice of pathologists as published in a national survey.