Vincent Misraï1, Sébastien Kerever2, Marie Pasquie3, Benoit Bordier3, Julien Guillotreau3, Julien Palasse4, Virginie Guillotreau5, Enrique Rijo6, Sébastien Vincendeau7, Romain Huet7, Romain Mathieu7, Benoit Peyronnet7, Nathalie Rioux-Leclercq8, Eva-Maria Compérat9. 1. Department of Urology, Clinique Pasteur, 31300, Toulouse, France. v.misrai@clinique-pasteur.com. 2. Lariboisière University Hospital, ECSTRA Team, CRESS, Epidemiology and Statistics Centre, and University Denis Diderot, Paris, France. 3. Department of Urology, Clinique Pasteur, 31300, Toulouse, France. 4. Department of Pathology, S.O. Path, Toulouse, France. 5. Department of Pathology, Les Feuillants, Toulouse, France. 6. Department of Urology, Hospital Quirón Salud, Barcelona, Spain. 7. Department of Urology, Rennes Hospital, Rennes, France. 8. Department of Pathology, Rennes Hospital, Rennes, France. 9. Department of Pathology, Tenon Hospital, AP-HP, University Pierre and Marie Curie, Paris, France.
Abstract
OBJECTIVE: This study sought to compare the incidental prostate cancer (iPCa) detection rate between pathological specimens from green laser enucleation of the prostate (GreenLEP) and open simple prostatectomy (OSP). MATERIALS AND METHODS: In two institutions, the charts of all consecutive patients who underwent OSP between January 2005 and December 2010 were retrospectively reviewed, and the data of all consecutive patients who underwent GreenLEP with tissue morcellation between July 2013 and January 2018 were also collected. Preoperative demographics and pathological findings were recorded. iPCa detection rate was retrospectively compared between the GreenLEP and OSP groups in a propensity score model, including all predetermined variables: Age, preoperative PSA level and prostate volume. RESULTS: Of 738 patients, 402 were included in the propensity-score matching analysis, and they were equally distributed among groups. The overall iPCa detection rates were similar in both groups (9.9% vs. 8.5%; p = 0.73), and there were no statistically significant differences in terms of tumour stage, Gleason score or the rate of clinically significant iPCa, although the number of cassettes analysed was significantly higher in the morcellation group than in the OSP group. No predictive factors for iPCa were identified. CONCLUSIONS: The results of the present study suggest that the mechanical morcellation of large glands had no influence on iPCa detection. Compared with a specimen from standard OSP, a large morcellated tissue sample allows adequate pathological evaluation and does not alter a pathologist's ability to detect iPCa.
OBJECTIVE: This study sought to compare the incidental prostate cancer (iPCa) detection rate between pathological specimens from green laser enucleation of the prostate (GreenLEP) and open simple prostatectomy (OSP). MATERIALS AND METHODS: In two institutions, the charts of all consecutive patients who underwent OSP between January 2005 and December 2010 were retrospectively reviewed, and the data of all consecutive patients who underwent GreenLEP with tissue morcellation between July 2013 and January 2018 were also collected. Preoperative demographics and pathological findings were recorded. iPCa detection rate was retrospectively compared between the GreenLEP and OSP groups in a propensity score model, including all predetermined variables: Age, preoperative PSA level and prostate volume. RESULTS: Of 738 patients, 402 were included in the propensity-score matching analysis, and they were equally distributed among groups. The overall iPCa detection rates were similar in both groups (9.9% vs. 8.5%; p = 0.73), and there were no statistically significant differences in terms of tumour stage, Gleason score or the rate of clinically significant iPCa, although the number of cassettes analysed was significantly higher in the morcellation group than in the OSP group. No predictive factors for iPCa were identified. CONCLUSIONS: The results of the present study suggest that the mechanical morcellation of large glands had no influence on iPCa detection. Compared with a specimen from standard OSP, a large morcellated tissue sample allows adequate pathological evaluation and does not alter a pathologist's ability to detect iPCa.
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