Prevalence and risk factors of incidental prostate cancer in certain surgeries for benign prostatic hyperplasia: A systematic review and meta-analysis
ABSTRACT Background: This study aimed to explore the prevalence and clinical risk factors in patients diagnosed with incidental prostate cancer (IPC) during certain surgeries (transurethral resection of the prostate [TURP], open prostatectomy [OP], and holmium laser enucleation of the prostate [HoL...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Urologia
2022-11-01
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| Series: | International Brazilian Journal of Urology |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382022000600915&tlng=en |
| _version_ | 1811314093555974144 |
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| author | Zhenlang Guo Junwei He Lijuan Huang Zhaohui Wang Ping Hu Shusheng Wang Zunguang Bai Jun Pan |
| author_facet | Zhenlang Guo Junwei He Lijuan Huang Zhaohui Wang Ping Hu Shusheng Wang Zunguang Bai Jun Pan |
| author_sort | Zhenlang Guo |
| collection | DOAJ |
| description | ABSTRACT Background: This study aimed to explore the prevalence and clinical risk factors in patients diagnosed with incidental prostate cancer (IPC) during certain surgeries (transurethral resection of the prostate [TURP], open prostatectomy [OP], and holmium laser enucleation of the prostate [HoLEP]) after clinically suspected benign prostatic hyperplasia (BPH). Materials and Methods: Literature search of the MEDILINE, Web of Science, Embase, and Cochrane Library databases was performed to identify eligible studies published before June 2021. Multivariate adjusted odds ratios (ORs) and associated 95% confidence intervals (CIs) of the prevalence and clinical risk factors of IPC were calculated using random or fixed-effect models. Results: Twenty-three studies were included in the meta-analysis. Amongst the 94.783 patients, IPC was detected in 24.715 (26.1%). Results showed that the chance of IPC detection (10%, 95% CI: 0.07-4.00; P<0.001; I2=97%) in patients treated with TURP is similar to that of patients treated with HoLEP (9%, 95% CI: 0.07-0.11; P<0.001; I2=81.4%). However, the pooled prevalence estimate of patients treated with OP was 11% (95% CI: −0.03-0.25; P=0.113; I2=99.1%) with no statistical significance. We observed increased incidence of IPC diagnosis after BPH surgery amongst patients with higher prostate-specific antigen (PSA) level (OR: 1.13, 95% CI: 1.04-1.23; P=0.004; I2=89%), whereas no effect of age (OR: 1.02, 95% CI: 0.97-1.06; P=0.48; I2=78.8%) and prostate volume (OR: 0.99, 95% CI: 0.96-1.03; P=0.686; I2=80.5%) were observed. Conclusions: The prevalence of IPC was similar amongst patients undergoing TURP, HoLEP, and OP for presumed BPH. Interestingly, increased PSA level was the only independent predictor of increasing risk of IPC after BPH surgery rather than age and prostate volume. Hence, future research should focus on predictors which accurately foretell the progression of prostate cancer to determine the optimal treatment for managing patients with IPC after BPH surgery. |
| first_indexed | 2024-04-13T11:05:50Z |
| format | Article |
| id | doaj.art-af2b4803098f4ef88ccb02d2bca0d770 |
| institution | Directory Open Access Journal |
| issn | 1677-6119 |
| language | English |
| last_indexed | 2024-04-13T11:05:50Z |
| publishDate | 2022-11-01 |
| publisher | Sociedade Brasileira de Urologia |
| record_format | Article |
| series | International Brazilian Journal of Urology |
| spelling | doaj.art-af2b4803098f4ef88ccb02d2bca0d7702022-12-22T02:49:17ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-61192022-11-0148691592910.1590/s1677-5538.ibju.2021.0653Prevalence and risk factors of incidental prostate cancer in certain surgeries for benign prostatic hyperplasia: A systematic review and meta-analysisZhenlang GuoJunwei HeLijuan HuangZhaohui Wanghttps://orcid.org/0000-0003-4261-7853Ping HuShusheng WangZunguang BaiJun PanABSTRACT Background: This study aimed to explore the prevalence and clinical risk factors in patients diagnosed with incidental prostate cancer (IPC) during certain surgeries (transurethral resection of the prostate [TURP], open prostatectomy [OP], and holmium laser enucleation of the prostate [HoLEP]) after clinically suspected benign prostatic hyperplasia (BPH). Materials and Methods: Literature search of the MEDILINE, Web of Science, Embase, and Cochrane Library databases was performed to identify eligible studies published before June 2021. Multivariate adjusted odds ratios (ORs) and associated 95% confidence intervals (CIs) of the prevalence and clinical risk factors of IPC were calculated using random or fixed-effect models. Results: Twenty-three studies were included in the meta-analysis. Amongst the 94.783 patients, IPC was detected in 24.715 (26.1%). Results showed that the chance of IPC detection (10%, 95% CI: 0.07-4.00; P<0.001; I2=97%) in patients treated with TURP is similar to that of patients treated with HoLEP (9%, 95% CI: 0.07-0.11; P<0.001; I2=81.4%). However, the pooled prevalence estimate of patients treated with OP was 11% (95% CI: −0.03-0.25; P=0.113; I2=99.1%) with no statistical significance. We observed increased incidence of IPC diagnosis after BPH surgery amongst patients with higher prostate-specific antigen (PSA) level (OR: 1.13, 95% CI: 1.04-1.23; P=0.004; I2=89%), whereas no effect of age (OR: 1.02, 95% CI: 0.97-1.06; P=0.48; I2=78.8%) and prostate volume (OR: 0.99, 95% CI: 0.96-1.03; P=0.686; I2=80.5%) were observed. Conclusions: The prevalence of IPC was similar amongst patients undergoing TURP, HoLEP, and OP for presumed BPH. Interestingly, increased PSA level was the only independent predictor of increasing risk of IPC after BPH surgery rather than age and prostate volume. Hence, future research should focus on predictors which accurately foretell the progression of prostate cancer to determine the optimal treatment for managing patients with IPC after BPH surgery.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382022000600915&tlng=enProstatic HyperplasiaMeta-Analysis as TopicPrevalenceRisk Factors |
| spellingShingle | Zhenlang Guo Junwei He Lijuan Huang Zhaohui Wang Ping Hu Shusheng Wang Zunguang Bai Jun Pan Prevalence and risk factors of incidental prostate cancer in certain surgeries for benign prostatic hyperplasia: A systematic review and meta-analysis International Brazilian Journal of Urology Prostatic Hyperplasia Meta-Analysis as Topic Prevalence Risk Factors |
| title | Prevalence and risk factors of incidental prostate cancer in certain surgeries for benign prostatic hyperplasia: A systematic review and meta-analysis |
| title_full | Prevalence and risk factors of incidental prostate cancer in certain surgeries for benign prostatic hyperplasia: A systematic review and meta-analysis |
| title_fullStr | Prevalence and risk factors of incidental prostate cancer in certain surgeries for benign prostatic hyperplasia: A systematic review and meta-analysis |
| title_full_unstemmed | Prevalence and risk factors of incidental prostate cancer in certain surgeries for benign prostatic hyperplasia: A systematic review and meta-analysis |
| title_short | Prevalence and risk factors of incidental prostate cancer in certain surgeries for benign prostatic hyperplasia: A systematic review and meta-analysis |
| title_sort | prevalence and risk factors of incidental prostate cancer in certain surgeries for benign prostatic hyperplasia a systematic review and meta analysis |
| topic | Prostatic Hyperplasia Meta-Analysis as Topic Prevalence Risk Factors |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382022000600915&tlng=en |
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