Histology of Prostate Chips from Turp Performed in Men with Needle Biopsy Diagnosed Prostate Cancer: A Preliminary Report.

Abstract

Introduction: Prostate cancer remains the leading cause of cancer related deaths in Nigerian men. Early detection and quick appropriate interventions remain key to possible cure. Transurethral resection of the prostate (TURP) for the treatment of men with prostate enlargement is gaining grounds in Nigeria due to increase in the number of Urologists with skills in the conduct of the procedure. The aim of this study was to evaluate the effectiveness of diagnosing prostate cancer through the histology of prostate chips from TURP. Methods: TURP chips of 23 men with needle biopsy diagnosed prostate cancer who had TURP due to worsening lower urinary tract symptoms (LUTS) despite earlier initiation of complete androgen ablation were sent for histology and the report analyzed. Result: Twenty three (23) men were included in the study. Mean age was 63.5 yrs. Mean PSA value was 23.68ng/ml. All of them had bilateral total orchidectomy plus 50mg daily bicalutamide. Mean duration from time of commencement of complete androgen ablation to time of TURP was 6 months. 14 samples (60.86%) showed adenocarcinoma with mean Gleason score of 7.6. Eight (8) samples (34.78%) showed nodular hyperplasia. 1 sample (4.35%) showed high grade PIN. Conclusion: Histology of TURP chips does not show high sensitivity in diagnosing prostate cancer. Thus men with high risk of having prostate cancer, for example, those with high serum PSA but with repeated negative needle biopsies who had TURP should be counseled to understand that negative histology of TURP chips is not a guarantee of freedom from possible prostate cancer.