Clinical study of incidental prostatic carcinoma

At the Center for Adult Diseases, Osaka, between 1961 and 1987, 28 cases (1.8%) of incidental prostatic adenocarcinoma were detected by transurethral or subcapsular prostatectomy for clinically benign prostatic hypertrophy (1388 cases) and cysto-prostatectomy for urinary bladder carcinoma (156). Nine (32%) and 19 (68%) cases were in stages A1 and A2, respectively. Of the 19 A2 cases, 9 were well, 9 were moderately and 1 was poorly differentiated adenocarcinoma. Five of the A2 and 1 of the A1 progressed into clinical carcinoma, but none of these patients died of the cancer. Four of these 5 A2 patients had received no treatment postoperatively and one received castration. The intervals from diagnosis to progression ranged from 11 to 78 months. The survival rates at 5 and 10 years with A1 were 75% and 75%, and those with A2 were 80% and 37%. We conclude that the patients in stage A2 should be treated because stage A2 tumors, especially those with no treatment, progress at a higher frequency than stage A1 tumors.