1988 Volume 79 Issue 10 Pages 1622-1626
Between January in 1977 and December in 1987, 1384 surgical interventions including transurethral resection (TUR) and open subcapsular removal of the prostate were done in the treatment of benign prostatic hypertrophy (BPH) at the University Hospital and the affiliate teaching hospitals. Postoperatively, 33 patients were incientally found to have cancerous foci on the histopathologic examinations of the surgically removed specimen from the patients with BPH. In the present study, patient chart was reviewed to assess the treatment modalities and prognosis in 33 patients with stage A prostatic cancer. In order to circumvent the pirfally of expensive and time spending hitopaghological examination for conventioanl subclassification of stage A prostatic cancer, the simplest clinical staging was employed to classify stage A1 and A2 diseases of incidentally found, namely occult cancer of the prostate. According to our proposed classification, a well and moderately or poorly differentiated prostatic adenocarcinoma of stage A noudules were respectively referred to A1 and A2. The analysis of the clinical observations is summerized as follow.
1) The thirty-three patients comprised 24 in stage A1 and 9 in stage A2 diseases.
2) Incidental cancer in the surgical specimen was found in 21 patients (1.9 percent) by TUR of 1120 operations and in 12 patients (4.5 percent) by subcapsular prostatectomy in 264 open procedures.
3) Of the 33 patients with stage A cancer, 28 was additionally managed by appropriate therapy and the remaining 5 received no further treatment.
4) A relapse was observed in 4 patients with stage A2 cancer although none of the patients with stage A1 disease relapsed.
5) All 3 patietns with stage A prostatic cancer survived through the follow-up period.
These clinical findings suggest that our subclassification of stage A prostatic cancer is easily applicable and replaces the conventional staging of stage A disease to select the patients for suitable further management in a clinical setting.
